Dr. Baeke subscribes to neither practice. When performed under local anaesthesia the surgeon is unable to focus 100% of his attention on the surgery. He is constantly thinking about what the patient might be feeling; thus making his technique timid. Also, an awake patient will be listening to the sounds of surgery (which is disconcerting to some) and the doctor is tempted to get involved in conversation with a talkative patient. All of this distracts the surgeon from concentrating on the procedure, and leads to less than perfect results.
In healthy patients, a general anaesthesia (patient asleep) is extremely safe. In the hundreds of liposuction cases performed by Dr. Baeke, there have been zero anaesthetic problems.
Liposuction involves making several small (~1/8th inch) incisions, usually 2 per area. These incisions are commonly placed in locations which are concealed, such as in the belly button. Through this incision, a very thin hollow stainless steel tube (called a cannula) is inserted. These tubes are about the diameter of a #2 pencil, or smaller. Suction through these tubes removes the excess fat.
Dr. Baeke will usually employ a special power-assisted device connected to these cannulae, which allows for more uniform fat removal in a shorter amount of time.
Typically, liposuction is performed using the "tumescent" technique. This time-honored technique involves injecting a solution of saline/lidocaine/epinephrine into the fatty layer. This also allows a greater and faster removal of fat, but provides nice post-operative pain control.
Dr. Baeke has experience using other techniques utilizing ultrasonic and laser technology, and believes these devices give inferior results.
The length of surgery varies by number of areas and amount of fat, but generally is ± 1 hour. You should plan on returning to your home or hotel that same day. As a cosmetic surgery patient, you should expect Dr. Baeke or one of his nurses to make a house-call on you the next day.
Patients will be advised to select a custom spandex-like compression garment (Dr. Baeke recommends Isavela garments) to bring to the surgery center. This you will awaken wearing. The purpose is to reduce any swelling and help assure smooth results. Also, important to quickly achieving your final result, is post-operative massage by a therapist trained in manual lymphatic drainage ("MLD").
MYTH: Liposuction is a cure for obesity.
Truth: Definitely not. Indeed, many of the best candidates for liposuction are already rather thin. Liposuction is for the individual who has isolated areas of fat which are diet-resistant, exercise-resistant and out of proportion with the rest of their body.
Typical areas patients request to have liposuctioned are: tummy, buttock, "saddle bags", thighs, knees and "bra fat",.
Q: I have heard about non-surgical procedures for fat removal which can be performed in the office, and for less money. Is this true?
Answer: Over the past 20+ years, devices have come and gone which have been promoted as alternative methods for fat removal. These gadgets hope to reduce fat via various modalities, such as freezing, ultrasound, vibration, etc. For patients desiring more instant gratification, treatment with these machines may not be the best answer as all require multiple sessions, spread over many weeks. Though true, the per session cost is less than liposuction surgery. The total cost over several sessions is comparable, often more.
MYTH: Non-surgical methods for fat removal are painless.
Truth: These methods all have some discomfort associated with them.
Q: I understand there is a new drug which can be injected to dissolve fat?
Answer: Yes. This drug is deoxycholic acid (Kybella®, Allergan, Madison, NJ) [www.mykybella.com]. The F.D.A. has only approved it for use in submental fat (i.e. "double chin"). Use of this medication involves making several small injections into the fat beneath the chin. Discomfort is minimal. As each session typically removes ±25% of the fat, most patients will request 3-5 sessions spaced several weeks apart. Dr. Baeke performs this procedure in his office.
Q: Can large breasts be reduced by liposuction?
Answer: Yes, in certain circumstances. In women, this technique is best reserved for those only desiring a small drop in cup size (~1 cup) and whose breast tissue is mostly fat (rather than dense gland).
Q: Can "man boobs" be treated with liposuction?
Answer: Yes, in fact, many consider liposuction to be the preferred treatment for gynecomastia. Again, it is important for the surgeon to be cautious, as too aggressive liposuction can leave the man with waves and irregularities in the chest skin. Further, best results are achieved with breasts that have more fat than fibrous glandular tissue. For further information, read the section information on "Man Boobs".
Q: Does insurance ever pay for liposuction?
Answer: Rarely, but in certain situations, yes. When performed as a continuation of post-cancer reconstruction it may be covered. Men with gynecomastia may be another covered situation.
To maintain great results, the patient must continue a diligent regimen of diet and exercise. Liposuction does not give you a carte blanch card for a carefree lifestyle.
Complications with liposuction are fortunately quite rare. Dr. Baeke can recall never having any.