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Dr. Binstock has included a number of commonly asked questions by
individuals who are considering liposuction surgery. His goal is to enable
you to feel secure in your knowledge and understanding of the procedure
so that you will be able to make an informed decision about the liposuction
surgery.
Who is a potential
candidate?
There is no definite age or weight limits. Most patients have localized
fat deposits and some of our happiest patients are within twenty to thirty
pounds of their ideal weight, and have been stable at that weight for
years. Some patients have certain bulges irrespective of their weight
and others are content with their weight, but would be more comfortable
if certain bulges were recontoured. The best candidates for liposuction
are in good health and have realistic expectations of the benefits of
liposuction.
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photos of Dr. Binstock's patients**
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Hips, outer thighs, inner thighs, and buttock
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Is Liposuction a treatment for obesity?
Liposuction is not an effective treatment for obesity and is not an alternative
to dieting. The procedure works best on those whose weight is stable and/or
have localized areas of fat deposits.
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photos of Dr. Binstock's patients**
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Chest, abdomen, and flanks
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What areas of the body can benefit from this technique?
The most frequently treated areas in women include the waistline, abdomen,
outer thighs, inner thighs, buttocks, knees, ankles, and neckline. In
men, the most commonly treated areas are the love handles, breasts, abdomen,
and neckline.
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photos of Dr. Binstock's patients**
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Liposuction of neck and jowls
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How is fat removed from the bulge areas?
A cannula is a hollow tube with an opening near its blunt end and is inserted
through small incisions beneath the skin and into the fatty tissue overlying
the body's musculature. This cannula breaks up the fatty tissue creating
a honeycombing of the fat. A vacuum pump connected to the other end of
the cannula then evacuates the loosened fat cells underneath the skin
surface through a series of openings at the tip end of the cannula. The
smaller the cannula, the smaller the tunnels and the more even the reduction.
The cannulas that Dr. Binstock uses are generally 1.3 to 4.0 mm in outside
diameter. In contrast, other surgeons often use cannulas 6.0 mm or larger
in size. After surgery, these tiny tunnels collapse resulting in an improved
body contour.
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photos of Dr. Binstock's patients**
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Hips, inner thighs, and abdomen
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How are the benefits of Liposuction measured?
The cosmetic success of liposuction relies on removing inches rather than
pounds. Little weight is actually removed and yet dramatic change in silhouette
is possible. Most important is the patient's satisfaction and increased
self acceptance.
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photos of Dr. Binstock's patients**
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Abdomen, waist, and hips
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The Tumescent Technique is the most significant
advance in Liposuction.
The Tumescent Technique is the most significant improvement in liposuction.
It effects liposuction totally by local anesthesia and thus avoids general
anesthesia. The technique is considered the safest form of liposuction
as blood loss is greatly reduced, post operative recovery time is reduced,
and the cosmetic results are optimized. The Tumescent Technique was developed
and refined by a dermatologist in 1985.
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photos of Dr. Binstock's patients**
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Liposuction neck & jowls, fat transfer to cheeks
and chin
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What does Tumescent mean?
The word "tumescent" means swollen or firm. This technique is accomplished
by injecting a large volume of a dilute solution of lidocaine, a local
anesthetic and of epinephrine, a vasoconstrictive drug which shrinks capillaries.
Patients find local anesthesia so effective that they have reduced pain
post operatively and in addition, no longer need IV sedation or general
anesthesia.
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photos of Dr. Binstock's patients**
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Outer thighs
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Can the procedure be performed in an office setting?
Liposuction is performed in our specially equipped in-office operatory.
The Tumescent Technique means liposuction can be performed totally by
local anesthetic. Single areas, i.e., neck, abdomen, knees, outer thighs,
etc., and multiple areas can be treated, in a given session, depending
on the number and size of the areas. General anesthesia is administered,
when necessary, by an anesthesiologist (not by a nurse anesthetist) in
a surgery center or hospital, where Dr. Binstock has privileges to perform
liposuction surgery.
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photos of Dr. Binstock's patients**
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Love handles
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Blood loss is greatly reduced.
The epinephrine in the anesthetic solution causes diffuse capillary constriction
that results in minimal blood loss during and after the surgery. Now 1%
of what is extracted is blood, and without the tumescent solutions, 25%
of what is removed is blood. Not only is recovery time reduced, i.e.,
your oxygen carrying capacity is preserved, but blood transfusions are
virtually unnecessary.
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photos of Dr. Binstock's patients**
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liposuction of jowls, lipo-fat transfer to cheeks
and chin
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Quick return to normal activities.
Home rest is necessary for the first twenty-four hours and then a light
work schedule may be resumed. If sculpting is more extensive and performed
in several areas, several days of recuperation may be necessary. A special
elastic garmet must worn for one week after surgery. The rate of healing
is accelerated as a result of the drainage of blood tinged anesthetic
solution the first day or two after the procedure. This drainage minimizes
bruising, reduces inflammation, and significantly accelerates healing.
Exercise appropriate for the individual can be initiated after 5 days
to help you develop a better platform upon which your skin will drape
and will heighten the improvement of body contouring.
How will the skin look after surgery?
Stretch marks, dimples, and ripples remain unchanged following surgery.
The changes following liposuction are analogous to those one would expect
if it were possible to lose an equal amount of fat in localized areas
by dieting alone. Smaller cannulas allow the fibrous connections between
the skin and body to remain. These contract or shorten during healing.
For this reason, excessive skin folds are rare and in fact, many patients
who would have previously required surgical excision of skin can have
excellent results with liposuction alone.
Are there any scars as a result of the procedure?
The Tumescent Technique uses very small cannulas, which result in smaller
incisions. Incisions are generally not sutured closed and heal with less
marking than those sutured. When possible they are concealed in natural
body creases; such as the end of the buttock fold, the umbilicus, under
the chin, or in the pubic hair. Sutures, if used, will dissolve by themselves
or be removed in our office following surgery.
Bruising is decreased.
Bruising is greatly reduced because the local anesthetic solution contains
epinephrine which constricts blood vessels, reducing bleeding, and therefore
bruising. The drainage of anesthetic solution following the Tumescent
Technique further reduces bruising as it contains blood cells that would
otherwise remain under the skin and appear as a bruise. By minimizing
bruising and swelling, the tumescent liposuction accelerates the rate
of healing.
Can fat re-accumulate in the contoured areas?
Fat cells are permanently removed as fat cells are thought not to multiply
after puberty. As long as the patient does not gain excessive weight,
the new silhouette is permanent. Fat removal however, does not allow for
abuse of diet later. Patients, after liposuction, have sometimes found
that areas treated by liposuction retain the new contour whereas areas
not treated have been new sites for fat development. As one gains weight
the size of the individual fat cells will increase and too much weight
gain may mask the benefit. The benefit will show when the extra weight
is reduced. People with prior weight problems still have to watch their
weight and exercise.
General anesthesia and IV sedation.
General anesthesia and IV sedation have inherent risks greater than those
of local anesthetic alone. In fact, fatalities associated with general
anesthesia are estimated to be one in ten thousand patients. These modalities
are available if desired by the patient or if Dr. Binstock feels they
are indicated. General anesthesia is administered by a trained and experienced
anesthesiologist.
What complications may occur?
Surgical complications of liposuction are quite rare. As with any surgical
procedure, liposuction is associated with common side effects such as
bruising, swelling, and numbness. Skin irregularities have been greatly
reduced because Dr. Binstock uses very small cannulas that effect a more
even and less traumatic reduction.
An article published in the Journal of Dermatologic Surgery and Oncology,
in 1995, reviewed the complications of 15,336 patients, all of whom had
their Liposuction performed totally by local anesthesia. A summary of
the findings includes: infection 0.34%, skin irregularities 0.26%, allergic
reaction 0.12%, persistent post operative swelling 0.09%, scrotal or labial
swelling 0.38%, hematoma or seroma 0.17%, focal subcutaneous fat inflammation
0.2%, permanent nerve damage 0.03%, excessive blood loss requiring transfusion
0%, anemia 0%, any complications involving hospitalization 0%, death 0%,
shock 0% pulmonary embolism 0%, phlebitis 0%, toxic reaction to IV sedative
or narcotic 0%.
Rare but significant complications can occur with any surgery and include
serious infection, necrotizing fascitis, pulmonary embolism (secondary
to blood or fat embolism), fluid imbalance, excessive blood loss, anesthesia
complications, perforation of an internal organ, and death.
As in any surgical or dental procedure, an unlikely allergic reaction
could possibly result in cardiac arrest. Dr. Binstock and his nursing
assistants are trained in ACLS (Advanced Cardiopulmonary Life Support)
and the equipment and drugs are available in the event of an emergency.
This information is not intended to frighten you but rather to enable
you to make your decision whether or not liposuction surgery is for you.
Following surgery, you should immediately report any signs of infection,
bleeding around the incisions, or anything else that causes you concern.
Who performs Liposuction?
Liposuction is a newer surgical technique that has been embraced by dermatologic
surgeons, cosmetic surgeons, and plastic surgeons. In fact, dermatologic
surgeons as well plastic surgeons are taught liposuction during their
residency training programs. The Tumescent Technique was invented by a
dermatologist.
Why don't more surgeons use the Tumescent Technique?
One of the most significant factors in determining which technique a surgeon
will use is time. From a surgeon's point of view, the surgery will take
less time when a general anesthetic is used. Plastic and cosmetic surgeons
commonly use general anesthesia.
Dr. Binstock performs liposuction using local anesthetic by the Tumescent
Technique. In years past, he performed hundreds of procedures under general
anesthesia and hundreds more with heavy IV sedation. Dr. Binstock feels
the Tumescent Technique is the best and safest way to undergo liposuction
sculpturing.
What about Ultrasound Assisted Liposuction?
Dr. Binstock no longer performs Ultrasonic Assisted Liposuction
as he found the benefits do not warrant the increased risks, costs, and
time associated with the procedure. This was the conclusion that had been
reached by most European surgeons who abandoned the technique several
years ago, at the same time it was beginning to become popular in the
United States. In fact, the two main companies in the United States, who
manufacture the ultrasonic machines, have both stopped production of these
units.
External Ultrasonic Assisted Liposuction, an American adaptation of this
technique, wherein the ultrasound is applied externally before, rather
than internally during the procedure, has failed to provide any significant
benefit or advantage over tumescent liposuction alone. Dr. Binstock has
abandoned this technique as well.
What is Power Assisted Liposuction?
Power Assisted Liposuction utilizes a regular type of liposuction cannula
that oscillates and moves back and forth a few millimeters at 5-8,000
times per minute. It does not melt or liquefy the fat, as is the case
in the ultrasound assisted procedure.
The Power Assisted method was supposed to enhance and improve the thoroughness
of the removal of the fatty tissue.
Dr. Binstock has found that the benefits of this new procedure
are minimal, and no longer uses the Power Assisted unit as part of his regular liposuction
procedure.
What about the costs of Liposuction?
Costs vary depending on size and number of areas in question. My fees
reflect the attention and expertise I bring to this artistic procedure.
During your consultation, you will receive a written quote which will
outline the anticipated costs, including the surgical fee, procedure room
fees, and anesthesia fees as necessary.
Is Liposuction right for me?
The best way to decide that is to speak with a surgeon who has a large
experience and specializes in liposuction, facial and body sculpturing.
It is important to find a surgeon who has an artistic touch and sensibility.
Speak frankly, ask questions, and explain your expectations. Having done
thousands of liposuction procedures, I can answer your questions, address
your goals and expectations regarding facial and body liposuction. During
your consultation, I will provide you with the facts to enable you to
make the decision that's right for you.
Although cosmetic surgery may not achieve perfection, its ultimate
goal is to achieve a natural improved appearance. And while liposuction
does improve facial and body contours, it does not improve cellulite or
other surface irregularities.
** Benefits depicted are actual and
not retouched.
Patient results may vary. Each set of photos reflects the benefit realized
by the person in that set of photos, and not necessarily the viewers final
results.
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