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Who is YOUR cosmetic surgeon?

Who is YOUR cosmetic surgeon?

I just read an interesting article in this months American Society of Plastic  Surgeons  journal. It looked at just exactly who was providing Cosmetic Surgery services in Southern California. Here’s a snapshot of what was found. 

Doctors providing Liposuction, the second most commonly performed cosmetic surgery in this country, came from a variety training backgrounds, some surgical and some not. The fields include Plastic Surgeons, ENT, Dermatology, Family Practice, Ophthomology, General Surgery, Ob-Gyn, Oral Surgery, ER, Radiology, Pathology, and Urology. The eye opening thing, in my opinion, is that about half of the represented specialties had no formal surgical training in their residencies. They learned Liposuction at weekend courses.

When you are considering cosmetic surgery, you need to take a close look at your surgeon’s credentials…they may not be what you think they are.

Lee Corbett, MD

Complications and Fillers

Injectible fillers in Louisville, such as Louisville Juvederm and Louisville Restylane, are some of the most commonly requested services requested in my Louisville Cosmetic Surgery practice. In the vast majority of cases, the injections are well tolerated with good results and happy patients.

Fillers have been extensively tested and are very, very safe. Most problems are actually not a result of the filler itself, rather a problem with injection technique.

Early problems are the most common ones we encounter and include redness and swelling. Bruising can occur if a small blood vessel is injured by the injection. With the exception of fat injections, an allergic reaction can occur with any filler but this is extremely rare with todays fillers.

Late problems are primarily related to granuloma formation. A granuloma is basically a scar reaction to the injected material. If this occurs it is typically 6 to 24 months after injection.

Lee Corbett, MD

Louisville Ky. Plastic Surgeon

Combining Cosmetic Procedures

Here in my Louisville Plastic Surgery office we are seeing our usual “Spring Rush”.  More than ever, it seems like patients are wanting to do more than one operation simultaneously. Common examples are a Louisville facelift with a blepharoplasty or a Louisville Breast Reduction with a Lousiville Tummy Tuck.

My opinion on combining procedures is based on many factors. First, I look at your overall health status. Secondly, I look at the scope of the procedures we are planning and their physiological impact, and finally we need to consider how much time it will take to get you in and out of the O.R.

My advice is to come in for a consultation, let me see your “wish list”, then we’ll take a look at your starting point. I can then map out a plan and we can then decide the feasability. Our consultations are complimentary.

Lee Corbett, MD

Louisville KY. Cosmetic Plastic Surgeon

Liposuction: Ultra Sonic

Back in about 1996, when I was doing my Plastic Surgery Residency, Ultra Sonic Liposuction was just hitting the scene and was all the rave.

In this technique, a solid probe is inserted into the fatty area to be treated. Ultra Sound waves are transmitted down the probe and pass into the fatty tissue. The physics are sort of complicated but in the end, the sound waves cause the fat cells to implode by increasing the pressure surronding the fat cell. Thus, the fat is broken down and then can be aspirated more easily using standard liposuction equipment.

The advantages of Ultrasonic Liposuction are the ability to treat large volumes of fat with minimal blood loss, less bruising, and possible skin retraction. The disadvantages stem from the heat the solid probe generates. The ultrasound waves make the probe extremely hot which necessitates larger incisions to keep from burning the skin edges and if the end of the probe hits the under surface of the skin it can burn a hole in the skin. These issues are not present with typical liposuction.

Ultrasonic Suction is still used but it’s popularity has declined substantially.

Lee Corbett, MD

Liposuction: Tumescent Technique

The “Tumescent Technique” is probably the way most people have heard of  in terms of Louisville Liposuction. This is because  the word “Tumescent” is often used to describe any technique that involves the use of wetting solutions.

But, this really isn’t accurate. The Tumescent technique of Louisville Liposuction is very specific in that the surgeon will infiltrate 3 to 4 times the amount of wetting solution as he/she plans to suction out. So a planned suction of 1000 cc’s calls for the infiltration of 3 to 4000 cc’s of wetting solution.

This technique is the preferred one if general anesthesia is not going to be used because it allows for substantially larger amounts of lidocaine to be used. It also keeps the blood loss to about 1% of the volume aspirated.

Lee Corbett, MD

Liposuction: Superwet Technique

This is my preferred technique for Louisville Liposuction…the Superwet Technique.

The super wet technique expands the concept of using the wetting soloutions, which is a mixture of Lactated Ringers, a type of IV fluid, Lidocaine for pain control, and Epinephrine which causes vasoconstriction to minimize blood loss. In this method, I add wetting solution to achieve a 1:1 ratio of infiltrate to aspirate. In other words, if I anticipate suctioning out 2000 cc of fat, I will first infiltrate the area(s) with 2000 cc’s of wetting solution. I then wait and allow the lidocaine and epinephrine to take effect before introducing the liposuction cannula.

With this method of Louisville Liposuction, blood loss drops to about 1% of the volume of fat removed. So we can suction out 2000 cc’s of fat and only lose 20 cc’s of blood. The typical person has 5600 cc’s of blood in their body so a 20 cc loss in inconsequential. You lose more than this when you have blood drawn for your yearly physical!

I find this technique very safe and it yields very nice results, at least in my hands.

Lee Corbett, MD

Liposuction: Wet Technique

With the high blood loss associated with the Dry Technique, surgeons evolved to using the Wet Technique for Liposuction.

The Wet Technique involves the placement of 200 to 300 cc of wetting solution into the fatty areas to be treated before suctioning. Wetting solution is IV fluid with Lidocaine for pain control and Epinephrine, which constricts blood vessels thus minimizing blood loss, added in.

This technique is another that I never use for my Louisville Liposuction cases. The reason, again, is it can lead to too much blood loss. Blood loss can range from 4% to 30% of the volume of fatty tissue removed.

Lee Corbett, MD

Liposuction: Dry Technique

The Dry technique has been largely abandoned in Louisville Liposuction. The reason is that it led to too much blood loss.

Dry liposuction was the first technique used. It was done under general anesthesia and liposuction cannulas were used to remove the unwanted fat without any fluid being infiltrated into the area. The result was blood loss equaling somewhere around 30% of the volume of fatty tissue removed. This was accompanied by significant swelling, bruising, hospital stays, and even transfusions.

In 2010, I suspect you will not find a Plastic Surgeon using the dry technique for Louisville Liposuction. I certainly do  not.

Lee Corbett, MD

All posts on this blog are presented by Louisville Liposuction Surgeon, Dr. Lee Corbett.

Options in Louisville Liposuction

I just completed the Plastic Surgery In Service exam. This is a comprehensive test that Plastic Surgery residents take each year to measure their knowledge base. Surgeons in practice can also take it to help ensure we are current with the ever expanding knowledge base within our specialty.

There were a lot of good questions about liposuction techniques so I thought I would use the next few blogs to explain the options you have for Louisville Liposuction. These include tumescent, dry, wet, superwet, ultrasonic, and laser liposuction.

Liposuction in Louisville Ky., like most parts of the country, remains one of the most frequently requested cosmetic procedures for Plastic Surgeons.

Lee Corbett, MD