SmartLipo - how do I choose between different treatment techniques?

These are excellent issues to bring up- I'll address them individually below, but my overall recommendation is to find a plastic surgeon with proper training and certification by the American Board of Plastic Surgery with whom you are completely comfortable- neither of these physicians may be right for you.  A lot of information can be found on this website, or the website of the American Society of Plastic Surgeons.  All members of this organization are properly trained and have the highest level of certification.  Check outhttp://plasticsurgery.org/ if you need help finding other surgeons...

1. Tumescent anesthesia is a type of local anesthesia pioneered by dermatologists.  This is an excellent modality for minimal and localized liposuction, but for significant results in areas of the abdomen, thighs, and love handles, I would recommend a more significant type of anesthesia.   Additionally, I would strongly suggest that the anesthesia is performed by a licensed anesthesiologist or experienced and licensed nurse anesthetist.  The fluid used as part of liposuction have significant effects on the type of and rate of IV infusion, as well as type and dose of drugs given.  I always play it on the safe side and have an experienced professional other than myself administering anesthesia, so they can ensure my patient’s safety from that standpoint and I can concentrate on performing liposuction.

2. Here I agree with the physician that says that lunges and such are not going to help.  Fat is lost through systemic mechanisms of aerobic exercise, combined with metabolic aspects of diet.  Fat is not lost in one particular area by exercising that area.

3. Three area liposuction, with adequate and monitored anesthesia, is OK as long as the amount of fat removed is not "massive" which is usually thought of as over 3-5 liters.  This again relates back to the fluid shifts that can be problematic with large volume liposuction and this needs to be considered carefully in your planning.

4. I agree with the physician who does not recommend significant exercise following your procedure.  I usually tell my patients not to do anything that makes them sweat for at least 2 weeks following any procedure.  In all surgery, blood vessels are cut and clotted, and you do not want to raise your blood pressure until these vessels are healed, in order that you avoid postoperative bleeding problems.

5. Stitching the access incisions is really rather irrelevant- I would not use this as a criteria for choosing a plastic surgeon.

6. I agree with no swimming for a month- I have my patients shower shortly after surgery, but I don't like them submerging in water until I'm certain that all the wounds have healed, and that their skin is "water tight".  Scabs on the incisions are not enough!

7. I have known excellent surgeons who are relatively new to procedures, and very experienced surgeons who I would not have operate on anyone I knew.  What is important is that surgeons attention to detail, safe approach, and proper training.  I would STRONGLY urge you to make sure that whoever operates on you is a real Plastic Surgeon and certified by the American Board of Plastic Surgery. 

8. I have my patients wear compression garments for at least 3 weeks, and then for another 3 weeks at night.  I would think that the physician that suggested a month would be closer to my preferences.

As far as your note goes, it sounds as though you know a couple of bad things about the aggressive physician by reference and not that much about the conservative one.  I would rather go with a relative unknown as opposed to someone who was a known entity but not in a good way!  What sounds more appropriate, to be honest, is to continue your search until you find someone who is properly trained and certified, with whom you are very comfortable.  Good luck!

-Dr. L

You might be making this decision harder than it needs to be.  Remember that aesthetic surgery is an art form and no 2 doctors have the same talent level.  True talent cannot be taught either. 

If you carefully inspect many photographs from each doctor you should probably see some differences in patients who resemble you.  Choose to go to the doctor whose results look better to you and listen to your gut instinct.  Avoid egotistical or boastful doctors.  Make sure they are both Board Certified Plastic Surgeons and don't hold against one the fact that they might seem conservative - that is usually going to serve you better in most instances.

You asked a very good question.  It can be extremely difficult to distinguish between two doctors doing the same procedure, particularly when they are telling you to do different things!

But I think I can help you...

The best results in liposuction are done by the best surgeon.  Period.  Whether it is tumescent, standard, VASER, Lysonix, power, or SmartLipo, it is the surgeon and not the technique.  I promise. 

There has never, ever, been any study which showed a notable difference in outcome between the procedure done by the same surgeon.  But---there is a huge difference between surgeons!

So open yourself up.  I know your questions were all about choosing a SmartLipo doc, but what you are looking for is a great result, it is not a particular procedure.  Even an orchestra doesn't hire a violinist just because he owns a Stradivarius!  The better violinist will always sound better, even on an inferior instrument (and there is no evidence whatsoever that shows any advantage to SmartLipo over the other techniques).

There are many excellent plastic surgeons in Charlotte.  Go to the website shown below and look in its surgeon finder.  Not only are all the docs there certified by The American Board of Plastic Surgery, but they are also members of ASAPS, the most exclusive group of cosmetic surgeons in the United States.

Remember, what you want is brilliant lipo, not Smartlipo!  And it is the surgeon that will make the difference.