Common liposuction questions – from my patients
Posted in: Blog | April 14, 2011 | No Comments »
With summer coming up – I’ve been performing A LOT of liposuction procedures the last few months! I’ve had the same few questions come up multiple times from my patients. Here is a quick Q & A of the most common questions.
Q. If I gain weight after liposuction will I need it again?
A. Your body genetically has a certain number of fat cells deposited in particular areas. Some people are just born with more fat cells in their abdomen, flanks, inner thighs and no matter what they do, they just can’t lose the fat there. Liposuction removes the total number of fat cells that has preferentially deposited in these areas. If you gain weight, each fat cell in the body gets bigger, but because you have fewer fat cells in liposuctioned areas, you should proportionately gain less in the liposuctioned areas. It is always a possibility that if you gain a lot of weight, you may need liposuction again.
Q. Can liposuction help me loose weight?
A. Liposuction is not a treatment for obesity or a substitute for diet and exercise. It is for re-shaping the body to treat areas that have a dis-proportionate amount of fat. Liposuction is ideally designed for pockets of fat in isolated areas that do not respond to diet and exercise. Also, the law limits the total amount of liposuction that can be removed at one time to 5L of liposuction for safety reasons. I always tell my patients to start with diet and exercise and to maintain a stable weight before undergoing liposuction. However, having liposuction often motivates patients who look better in their leggings or workout clothes, to begin a healthier lifestyle, and many people lose even more weight after their procedure.
Q. Is liposuction is dangerous?
A. Any surgical procedure has risks of anesthesia, risks of getting a blood clot, and a number of other complications. Many of the serious complications from liposuction in the past involved cardiac reactions to the local anesthesia injected in the body before the procedure. Also, procedures involving large volumes of liposuction (> 5L) resulted in fluid shifts that caused cardiac and respiratory problems. These occurrences are now quite rare. A safe, well-trained surgeon will carefully calculate and keep track of the amount of local anesthesia used as well as the amount of liposuction removed. A partnership and good communication with the anesthesiologist will help to ensure the safest conditions possible.
Q. I’m fit and everyone tells me I’m in shape and don’t need anything done, but I hate the pocket of fat that bulges – am I still able to have liposuction?
A. I would say that the ideal candidate for liposuction is someone who is of healthy height and weight with small pockets of fat that they just can’t lose despite diet and exercise. As long as there are a few centimeters of fat present in an area, it can be removed. Many of my patients are very fit bikini models who don’t like the extra fat bulge or shape of their inner or outer thigh, or feel that they have a “muffin top” making their waistline bigger than desired. Liposuction is ideal for this type of re-shaping. I had an extremely small amount of fat removed from my knees and inner thighs over 10 years ago when I was modeling – so I can really relate to wanting removal of these small fat pockets. On the other hand, I have turned away patients who just didn’t have enough fat to be removed. In general, if you’re unsure, it’s best to see a plastic surgeon in consultation to evaluate your particular anatomy and decide if you are a candidate for liposuction.
Q. I’ve seen some bad liposuction – what happened there?
A. I know exactly what you are talking about – I can spot bad liposuction a mile away. There is always the possibility of asymmetry, skin dents, wrinkling, or folding. However, an experienced liposuction surgeon should be able to avoid most of these things from happening. Most of the really bad liposuction results often come from over suctioning the fat causing the skin to stick unnaturally to the underlying structures. I always tell patients that I have to leave a small cushion of fat under the skin to keep this from happening. I do the majority of the fat removal through surgery, and they do the rest with diet and exercise.
Q. Why do I have to wear compression garments?
A. The liposuction cannulas make tiny tracks as they remove fat. I tell patients to imagine a sponge with small holes. The compression garments help squeeze all the fluid and tissues down to allow for a smooth flat thin contour. They are sometimes cumbersome to wear, but worth it to have the best possible outcome. One of my celebrity liposuction patients who had to do several red carpet events soon after her surgery found some compression garments that give a nice smooth contour under clothing. I now use these often for my patients so the garments are less obvious under clothing.
I hope this helped answer most of your questions! Please remember that liposuction as well as any plastic surgery procedure should always be performed with a good understanding between patient and doctor of realistic expectations, and with an emphasis on safety.
Dr. Catherine Begovic M.D.
Breast implant operations have increased 40% in the last 10 years
Posted in: Blog | March 25, 2011 | No Comments »
New data from the American Society of Plastic Surgeons show that breast enhancement surgery continues to increase. Last year, surgeons performed 296,203 breast implants – a 2% increase from 2009 and a 39% increase since 2000.
Overall, doctors performed 13.1 million cosmetic procedures in 2010, a 5 % increase compared with 2009.
How does this relate to you? If you are considering a plastic procedure you likely know someone who had it done. I always recommend patients get as much information as possible before proceeding with a procedure. Sometimes it’s helpful to talk to friends who had the procedure done to get their perspective.
Regardless, you should always feel comfortable talking to your surgeon and asking as many questions as possible about results, recovery, and what to expect.
UCLA plastic surgeons perform first hand transplant in California.
Posted in: Blog | March 22, 2011 | No Comments »
I’d like to share a remarkable story from the Plastic & Reconstructive Surgery department at UCLA where I received my training. When it comes to Plastic and Reconstructive surgery, many people instantly think of cosmetic surgery – breast augmentations, rhinoplasty, lip filler, botox. Although that makes up a large part of many plastic surgeons’ practice, Plastic & Reconstructive Surgery is a broad field and includes breast reconstruction for breast cancer patients, cleft lip and palate surgery for children, facial reconstruction after trauma, chest wall reconstruction for patients with complications after cardiac surgery, as well as hand surgery to name a few. Every plastic surgeon who went through an accredited plastic surgery training program is versed in all areas of Plastic & Reconstructive Surgery.
This month, a young mother who lost her right hand in a traffic accident five years ago was the first person to receive a hand transplant in California and the 13th in the U.S. She couldn’t tie her shoelaces or braid her daughter’s hair. This was performed at the UCLA hand transplant unit of the Plastic & Reconstructive Surgery Department. The goal of plastic surgery is to make patients whole again and to improve their quality of life. I’m incredibly proud to have trained at an institution that helped this young woman get her life back again.
Dr. Catherine Huang Begovic
There is help for those under-eye hollows! Refresh your look with filler.
Posted in: Blog | February 25, 2011 | No Comments »
I spoke with a friend of mine today about facial fillers. She has some hollowing under her eyes creating a dark shadow and wondered what could be done about it. Aging is a combination of gravity pulling structures downward and a loss of facial fat. Fillers can re-fill the areas where there is loss of volume resulting in a more restored, more youthful look. Some fullness over the cheekbones also gives an aesthetically appealing highlight.
This procedure is performed in the office, usually with just topical anesthetic cream and some ice. However, this area is very vascular, so bruising is not uncommon. I advise patients to make sure they are off all aspirin or anti-inflammatory medications for at least a week and not to have any upcoming events or photo-shoots. It’s one of the quick fixes that helps people look much more refreshed. My patients who are on film or on TV tell me that the intense set lighting really makes the hollows more noticeable. After placing filler in these areas, they’ve noticed a significant change.
Dr. Catherine Begovic M.D.
Allergan Confidence Plus and Mentor Standard Advantage – Breast implant warranty programs
Posted in: Blog | January 9, 2011 | No Comments »
Women, who have or intend to get breast implants, should be aware that they are covered by warranty programs offered by companies who manufacture them. That means that if you get implants from them, they will help cover fees and give you a lifetime product replacement option.
I have breast implants so this information gives me peace of mind. Once you get an implant, you will be given a card with information about your implants like the serial number, kind, size, etc. You should keep this card so when the need for a replacement arises, it will be more convenient for you and the company to facilitate the application of the warranty.
Allergan and Mentor offer free warranty programs and upgrades. Below is some information that you should know about the warranty they offer patients.
Allergan breast implants are sold under the brand name Natrelle®. Every implant, be it saline or silicone gel, comes with the ConfidencePlus® warranty upon surgery. There is also the option to upgrade to ConfidencePlus® Premier warranty.
ConfidencePlus® covers recipients of both NATRELLE™ style saline and silicone filled breast implants instantly, for free. Coverage is as follows:
- 10 years of guaranteed financial assistance
- Financial assistance of up to $1200 for surgical fees, operating room and anesthesia fees, if not covered by your insurance
- Lifetime product replacement on the deflated side without charge
- Non cancellable terms
If you choose to upgrade to ConfidencePlus® Premiere, you will enjoy more benefits for only $100. You would have to do this change within 45 days of your surgery. Coverage is as follows:
- 10 years of guaranteed financial assistance
- Financial assistance of up to $2400 coverage for surgical fees, operating room and anesthesia fees, if not covered by your insurance
- Implant replacement on the opposite (non-deflated) side for 10 years after surgery
- Lifetime product replacement without charge
- Automatic renewal to ConfidencePlus® after replacement, for free.
- Non cancellable terms
Mentor have saline and silicone implants. The silicone gel implants are branded as MemoryGel®. Upon getting Mentor breast implants, you instantly get the Mentor Standard Advantage warranty for free, which includes:
- Free lifetime product replacement
- Financial assistance of $1200 for the cost of replacement surgery for 10 years after surgery.
- Implant replacement on the opposite (non-deflated) side for 10 years after surgery.
If you choose to upgrade to Mentor Enhanced Advantage, you only have to pay $100. You will get to enjoy all the benefits of standard warranty and increase the financial assistance amount from $1200 to $2400.
Since the warranty details do change, make sure to regularly check the details on the manufacturer’s website so that you’ll know your coverage.
Dr. Catherine Huang Begovic
Say goodbye to flappy flabby arms!
Posted in: Blog | December 21, 2010 | No Comments »
Does your upper arm keep swinging after you wave goodbye? Most women who have gained or lost a significant amount of weight have this problem. However, even fit women have upper arm fat that just won’t go away – myself included!
Don’t worry about having to deal with all this arm flapping forever. For mild cases in otherwise fit patients with good skin – upper arm liposuction should allow for a nice contour. This month, I’ve been doing many of these procedures for several of my young patients who work out and are in great shape but just need help with that last little area of upper arm fat.
However, for patients who have a lot of excess skin, they often need an arm lift or brachioplasty. This is about a 3-4-hour procedure that I perform at my outpatient surgery center. You will be under general anesthesia but you will get to go home the same day.
For either procedure, you can usually go back to work in a few days and exercise may be resumed just after a few weeks. Bruising is rare but there is swelling as with any liposuction procedure. For best results, you will need to wear compression garments preferably for about 6 weeks.
The main downside to brachioplasty is a long scar. It will extend from the armpit to the elbow, along the inside of your arm. In general, those with very loose skin find this exchange worthwhile. Those with only a small amount of sagging will sometimes be able to get away with a smaller scar in the armpit. If you are not willing to accept scarring, you should not have this operation. However, most patients are happy to trade their excess arm skin and fat for a scar.
Overall, patients are very happy with this procedure. Most women feel more confident wearing short sleeves and are less self conscious with everyday activity. As with all procedures, make sure to spend time discussing with your surgeon realistic expectations and making sure all your questions are answered prior to undergoing this procedure.
Dr. Cat Begovic M.D.
The importance of a pre-op history and physical exam
Posted in: Blog | December 15, 2010 | No Comments »
Before performing any procedure, minor or major, my number one priority is the patient’s safety. An important part of the process is a pre-op medical clearance.
I make sure an internist checks each patient’s complete medical history and physical condition. I do this to make sure that he or she is healthy enough to undergo general anesthesia. I also personally communicate with his or her doctor to discuss the patient’s medications, what kind of surgery is to be done, and how long he or she will be under anesthesia. Based on this information, the patient’s internist can determine the safety of under going surgery, and wecome up with a plan together for any medical issues that may arise. I believe good communication is essential for the patient’s safety. I also personally review the pre-op history and physical exam results with my anesthesiologist to make sure that he/she is 100% comfortable and well prepared. I consider the three of us a team and this pre-surgery safety check helps ensure that the patient will have a safe and positive experience.
Sometimes patients feel that it is inconvenient to go through all the tests and lab work, but without proper pre-operative evaluations, there can be serious consequences. There was a bill signed in 2009, the Donda West Law that mandated all patients undergoing elective cosmetic surgery have a medical history, physical exam and signed clearance from all doctors concerned before the procedure. This bill was created after the passing of Dr. Donda West, the entertainer Kanye West’s mother, who underwent surgery without proper clearance and died. The bill has since then been vetoed, but that doesn’t take away the importance of medical clearance.
This is just the first step in the process to having a safe and positive plastic surgery experience!
Dr. Catherine Huang Begovic
Do breast implants need to be changed every 10 years?
Posted in: Blog | | No Comments »
Just last week, at least 4 or 5 of my girlfriends who have breast implants asked me this question. I’m not sure how this idea started, but most women think that their breast implants need to be changed routinely. This is not the case – really, implants only need to be removed and replaced if there is a problem. In most cases, the problem involves implant leaks or scar tissue forming around the implant, known as “capsular contracture”. This scar tissue makes the breast feel firm, distorted, or uncomfortable. In the surgery, the scar tissue, or capsule, will also be removed.
Leaks are another reason to replace implants. If a woman has saline implants, it will be obvious if there is a leak. The implant slowly deflates as the saline solution leaks out. If a woman has silicone implants, it is sometimes difficult to detect a leak. This is why the FDA recommends screening for silicone leaks 3 years after implant placement and then every 2 years. Sometimes there are symptoms such as hard lumps, distortion of the breast or implant, swelling, burning, or hardening of the breast. If that happens, the implant should be removed.
Before getting a breast augmentation surgery, ask your doctor about the pros and cons of the procedure. Women who are considering implants should know that they are committing themselves to multiple surgeries over their lifetime. The good news is that if an implant needs to be replaced, the manufactures currently provide new implants for free and often cover part of the surgery fees as well.
Dr. Cat Begovic