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Author Topic: I have a question about two liposuction procedures I've had - male  (Read 7290 times)

Offline jltsk

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Hello.  I am a 43 year old male.  I have a very specific question about two lipo procedures I had.  I will be detailed in my description for accuracy.

A few years ago I had an Aqua-lipo procedure in Florida on my abdomen and love handles. At the time I was 5'10" and about 175-180.   Before the procedure, I did REAMS of research and homework to try and ensure things worked out well.  My weight was not excessive, except for the abdomen and love handle area.  Even if I dieted to the point where I looked nearly gaunt (165), I still had a layer of fat in the abdomen and around the sides.

There were no complications with the procedure.

After healing, I noticed that there seemed to be absolutely no difference in my appearance.    I consulted the doctor and he insisted he worked on me until all of the fat in the area between the skin and abdominal wall was removed.  He also suggested this may be inter-abdominal fat, but this is not the case as I can tighten my abs and a large amount of fat remains outside of it and I can feel my tight abs underneath.  When I say a large amount of fat, I mean a large fistfull. I can Pinch 4-5", maybe 6.  Now, when receiving lipo, everybody seems clear that you need to be careful that you should avoid gaining weight as the areas where you have lipo will not grow.  However, if I gain weight my abdomen blows right up, no problem.

He agreed to examine me in person.

When he did so, he said that all of the fat in my abdomen was simply skin.

I then went to a dermatologist.   I asked him his opinion on the skin on my abdomen.  He said skin, almost everywhere, is no more than about a centimeter thick.  I asked him if he thought I had grotesquely thick skin.  He looked at me like I was nuts and said no, you have abdominal fat and lots of it.  (I already knew this. Do you have any idea how silly it feels to pay a dermatologist $120 to confirm for you that you have visible abdominal fat?)   So I asked him to write me for a CT scan.

I had the CT scan and the doctor reading the scans also confirmed large areas of abdominal fat. (I have these)

So I went back to the original doc with my findings, and he agreed to redo the procedure.  This time he went more slowly, and took his time.  I'm quite sure he was attempting to make sure he didn't do this a third time.

After the second procedure..... I looked the same!

I have seen hundreds of other lipo pictures, and in many or most there is a dramatic change in appearance, especially in men.  I work out and I have what feels to be a defined abdominal wall.  I have seen before pictures of men with ab fat, and after pictures where there is no fat present at all, and the muscles are showing through the skin.

So my question is, what do you think is happening here?  Aqua lipo was supposed to do less tissue damage, but does it also not remove fat like it should?  There is no mistaking the fact that I have a plainly visible amount of abdominal fat.  This is clearly not just skin unless skin can be several inches thick. I'm beginning to think I'm the only thin person in the world that can have two lipo procedures and still be fat afterwards. One of the blog posts here even shows a doctor took out too much fat of someone else and left not enough between the skin and abs, so obviously something is going on with me, my doc, or my procedure.

Thanks for taking the time to read this.

-J




Offline DrBermant

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Re: I have a question about two liposuction procedures I've had - male
« Reply #1 on: October 06, 2012, 03:24:04 AM »
Hello.  I am a 43 year old male.  I have a very specific question about two lipo procedures I had.  I will be detailed in my description for accuracy.

A few years ago I had an Aqua-lipo procedure in Florida on my abdomen and love handles. At the time I was 5'10" and about 175-180.   Before the procedure, I did REAMS of research and homework to try and ensure things worked out well.  My weight was not excessive, except for the abdomen and love handle area.  Even if I dieted to the point where I looked nearly gaunt (165), I still had a layer of fat in the abdomen and around the sides.

There were no complications with the procedure.

After healing, I noticed that there seemed to be absolutely no difference in my appearance.    I consulted the doctor and he insisted he worked on me until all of the fat in the area between the skin and abdominal wall was removed.  He also suggested this may be inter-abdominal fat, but this is not the case as I can tighten my abs and a large amount of fat remains outside of it and I can feel my tight abs underneath.  When I say a large amount of fat, I mean a large fistfull. I can Pinch 4-5", maybe 6.  Now, when receiving lipo, everybody seems clear that you need to be careful that you should avoid gaining weight as the areas where you have lipo will not grow.  However, if I gain weight my abdomen blows right up, no problem.

He agreed to examine me in person.

When he did so, he said that all of the fat in my abdomen was simply skin.

I then went to a dermatologist.   I asked him his opinion on the skin on my abdomen.  He said skin, almost everywhere, is no more than about a centimeter thick.  I asked him if he thought I had grotesquely thick skin.  He looked at me like I was nuts and said no, you have abdominal fat and lots of it.  (I already knew this. Do you have any idea how silly it feels to pay a dermatologist $120 to confirm for you that you have visible abdominal fat?)   So I asked him to write me for a CT scan.

I had the CT scan and the doctor reading the scans also confirmed large areas of abdominal fat. (I have these)

So I went back to the original doc with my findings, and he agreed to redo the procedure.  This time he went more slowly, and took his time.  I'm quite sure he was attempting to make sure he didn't do this a third time.

After the second procedure..... I looked the same!

I have seen hundreds of other lipo pictures, and in many or most there is a dramatic change in appearance, especially in men.  I work out and I have what feels to be a defined abdominal wall.  I have seen before pictures of men with ab fat, and after pictures where there is no fat present at all, and the muscles are showing through the skin.

So my question is, what do you think is happening here?  Aqua lipo was supposed to do less tissue damage, but does it also not remove fat like it should?  There is no mistaking the fact that I have a plainly visible amount of abdominal fat.  This is clearly not just skin unless skin can be several inches thick. I'm beginning to think I'm the only thin person in the world that can have two lipo procedures and still be fat afterwards. One of the blog posts here even shows a doctor took out too much fat of someone else and left not enough between the skin and abs, so obviously something is going on with me, my doc, or my procedure.

Thanks for taking the time to read this.

-J

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Welcome to our discussion group. Liposuction is not an alternative to losing weight. Lipo will also not tighten loose skin.

When a BMI Body Mass Calculator comes up with overweight, then the chance the individual will still look overweight after surgery. BMI alone was not enough. Each of my patients also had Body Fat Analysis before I made a recommendation to using Liposuction for body sculpting.

I have seen patients unhappy after surgery done elsewhere with too much left behind, too little left: skin scarred down to fascia, and variations in between. The question when I was evaluating such conditions was to establish the original problem, what was done, and what currently is going on.

The Anatomy of Stomach Skin Around the Belly Button I built to demonstrate the nature of loose skin and fat on this central focal point. Removing normal fat, when loose skin is the distorting contour component can make for a more deflated unnatural look. This worsens as adhesions form between skin and underlying fascia when there is no fat left to lubricate the natural movement of structures. 

I also evolved a series of Standard Tummy Tuck Stomach Pictures to critically document loose skin vs fat as contour issues. Tummy Tuck Videos were even more critical in documenting skin, vs. scar, how tissues moved issues: something I found quite important when documenting a patient coming to see me after having surgery elsewhere and unhappy about the results.

Part of surgical sculpture is judgement. When to operate and on what to operate is part of the art of this specialty. I built tools on How to Pick a Tummy Tuck Surgeon that can be used to discuss selecting a Liposuction surgeon. A prime feature is critically looking at that specific surgeon and technique. Our How to Evaluate Tummy Tuck Pictures can be used to evaluate someones liposuction work, which is a component of Tummy Tuck sculpture. Operate on the wrong problem with the wrong tool and failure is a likely outcome. I do not believe a manufacture's hype about their product until I see results showing how the tissues move and the path taken between the before and after (typically not shown). Unless they can match what I was achieving, and I could not find any that did, I rejected their offers to try their products. I used my Bruisiing Swelling and Recovery After Tummy Tuck documentation which is much more extensive surgery and a measuring point to compare liposuction damaging tissue less claims. Less damaging surgical techniques should be able to demonstrate less bruising, swelling, and discomfort as well as less scarring shown with how tissues move.

A pinch test is often more valuable than a CT scan in assessing what liposuction will help. A CT scan is done on the patient's back, gravity pulls everything back. The equivalent is taking before after pictures of the abdomen with the patient lying down, not normally done and one is comparing apples and oranges for skin issues. CT scans also do not show well when there are scar adhesion issues distorting a bad result. The CT scan is static, and unless I am there in the scanner looking dynamically at the tissue during the scan, comparing it with the clinical exam, I will trust my hands on more than a CT scan in determining if I would have offered further surgery although if a patient already had a CT scan I would put that up on my viewer and use that in conjunction with my clinical exam to better understand the anatomy. You can see me performing a pinch test during this Male Chest Exam for Gynecomastia.

You are welcome to post your before surgery pictures and then a standard set now. Show the extra fat by pinch test to see if it is truly fat or just excess skin, but the Standard Views are quite revealing in this factor. How does the result compare to the doctor's before and after surgery photos? How much of the contour was loose skin vs fat between the skin and external structures, where liposuction targets? After removing references to the identifying information on the CT scan, they also can be posted.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
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Michael Bermant, MD
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Offline banned liposuction portal site

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Re: I have a question about two liposuction procedures I've had - male
« Reply #2 on: November 07, 2012, 04:24:06 AM »
I read carefully your message and i think it just doesn't make sense.. the only explanation i can give is that the doc didn't something wrong! Wet Liposuction [nofollow] is definitely an efficient method!

Offline DrBermant

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Re: I have a question about two liposuction procedures I've had - male
« Reply #3 on: November 07, 2012, 07:50:04 AM »
I read carefully your message and i think it just doesn't make sense.. the only explanation i can give is that the doc didn't something wrong! Wet Liposuction is definitely an efficient method!

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Tumesent Liposuction revolutionized our sculpture options in the operating room. The it enabled so much and I was privileged to be learning my craft as the method was introduced and then myself contributed my own evolution of its methods and use.

I find your post from a now banned liposuction portal, intriguing. I have personally treated and seen so many patients from so many doctors from around the world. I had to many requests for help from individuals unhappy after liposuction done elsewhere I went back and started a review and found over 500 such requests for help in only a few years. Fixing Failures of New York Gynecomastia Liposuction Surgery is one of the many pages I posted about that unfinished project.

Sorry, not the poster may not have been wrong. But I have posted only a few of the many nightmares I saw documenting how bad the tissues moved or other issues of various methods of different techniques.

It comes down to selective blinders vs. a more complete method of documentation. You can see that principle in this resource: Using Before After Pictures

Flexing Failure Crater Deformity After Revision by New York Surgeon - Original Gynecomastia Surgery Done in New Jersey demonstrates how Static Pictures Can Hide Deformity Seen in Real Life, Flexing, and Moving Muscles. It is all about learning to show what really happens with any method vs. limiting what is shown like a bad used car salesperson not letting the customer walk around the car to see the crushed rear end. If something works, or does not, there should be way to let such details come out before someone else ends up unhappy with results different than "expected" by a method that may not really offer what is "advertised."

Efficient surgical tools are a blessing to any surgeon making our work easier. The question becomes at what cost to the tissue? How will the tissue look and move after surgery was much more important to me than a quicker operation when dealing with elective surgery. The consummate surgical sculptor uses such options when  surgical tool offers them. Cautery or the device used to cut tissue with electric current is a prime example. These electric knives or cauterizing units can be fine tuned for what is needed. For my trauma life saving operations where every second counted, I needed to cut faster, more efficiently. Life and limb were on the line. But when I could afford to take my time and sculpted tissue could be babied, I adjusted the settings to minimize bruising, swelling, trauma to the tissues I was working on. Yes, much less efficient of my time, but oh how much better my patients looked and felt based on the more critical careful looking at a more detailed before and after documentation method.

So efficiency alone is just not enough for me, unless I needed it due to different priorities for the patient, not myself.

Our Forum, Advertisers, and Those Seeking A Better Way to Knowledge and Proof of Technique
This forum welcomes such documentation and links to proof of a technique. The goal here is to separate verbal hype and hand waving from reality and real results. Link spam to such non proof pages for search engine optimization will be deleted and the user banned until they understand our purpose here. Bans can be lifted and the member restored to a contributory role. But for now unpaid link advertisements have been removed.

We are working on a method for those who just want to advertise here, to be given that option without such documentation, but that material will have the label advertising so the public can judge for themselves. Contact us if interested in being part of this process of public empowerment here on this forum and connected resources or if you want to explore advertising opportunities for advertising your liposuction portal here. Posting with links that work are an earned prerogative presently.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Liposuction Body Contouring

Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
Plastic Surgery
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