IN QUEST FOR BEAUTY, MORE SELECT LIPOSUCTION Q&A

BYLINE: Sonja Isger Palm Beach Post Staff Writer
DATE: April 29, 1999
PUBLICATION: The Palm Beach Post
EDITION: FINAL
SECTION: ACCENT
PAGE: 3E

A taut tummy. Less-lumpy legs. A chiseled chin.

When Americans head to the doctor to retool what they see in the mirror, liposuction is their procedure of choice. Last year, nearly 150,000 people had fat sucked from their bodies. That's about 40,000 more than had the same procedure in 1996 and three times the number who sought liposuction in 1992, according to the American Society of Plastic and Reconstructive Surgeons.

Advances in technology account for part of the boom. Doctors can now use ultrasonic equipment or inject fluid into the targeted pockets and pull out more fat as a result.

That leap means people can see more dramatic results, but it also may expose them to more risk of serious medical complications. Doctors and professional associations say liposuction is still safe, but patients should be educated first.

West Palm Beach plastic surgeon Dr. Fred Barr and San Francisco author on plastic surgery Dr. Alan Gaynor answered questions about the procedure:


Are liposuction and lipoplasty the same thing?

Both: Yes. They refer to the removal, reduction of fat in specific body areas.
Must you have all areas done at once?

Gaynor: No, but it saves a lot of time and money if you do. It takes about $600 to set up an operating room. If you want to do your stomach one day and the hips another, that's $600 each time. It's certainly safer to do it once than several times. But beware of ``selling up.'' Some doctors, for example, will tell you, if you do your stomach your hips will be out of balance, so you should do them too. That should send up flags.


Is this a reasonable alternative to dieting or other medical procedures?

Barr: No. It is not. It will never be a replacement.

Gaynor: Unrelated. If someone is obese, liposuction is not an answer. But liposuction is not forbidden on overweight people.


What if I'm not overweight at all, but have saddle bags or a stomach pooch that won't go away? How much fat has to be there to qualify for the procedure?

Barr: There really isn't a minimum. It becomes an issue of what the patient is concerned about. We are ``hang-up physicians.'' We are here to help people with their hang-ups.

Gaynor: Any that's disproportional. You can take out 2 ounces or 2 pounds on a large portion. You're going after part of their figure they could never fix on their own.


Can it turn me into a bikini model?

Barr: I think the issue of unrealistic expectations should be addressed here. If somebody is already a model and spent a significant amount of time working on their bodies to be what they need for their career, and then they come in, fine. If you have somebody who is not modeling, has a sedentary job . . . to say you're going to be spectacular is unrealistic.

Gaynor: To get someone to look phenomenal with liposuction, they have to had a good body. Each person can be taken a certain distance.


Can you be too old for liposuction - too old for your skin to snap back?

Gaynor: In the stomach, yes. But there are 80-year-olds that you can improve their saddle bags. And then again, you can't do all 25-year-olds either.


How many incisions do you make? How big are they? And do they scar afterwards?

Barr: Usually the incisions are about one-half inch or less. At least one, sometimes two, sometimes three. Everybody has a scar. Obviously, as plastic surgeons, we try to hide them. But they may raise up, discolor, become numb.

Gaynor: The ones that show a bit more are on the hips because there's no natural place to hide them. So then I tell my patients to bring a bikini so we can put it on the bikini lines.


What anesthesia is used ?(Am I awake for the operation? Do I feel anything?)

Barr: Everybody has their own method. I use spinal or general. My patient would be asleep. People do them awake under conscious sedation.

Gaynor: For stomach-only or hips-only, you can use local, but others might use IV medication. For the whole body, you can use general, epidural where they're awake - like Clinton had when he hurt his knee - or something in between.


Can you take the fat out and put it somewhere else, such as my lips, during the same operation?

Barr: You can with traditional liposuction. Not with ultrasonic (where the fat is emulsified before removal). The only thing of controversy is putting fat in the breast areas.

Gaynor: I'm the king of that. I took it out of Geraldo's buns and put it in his face.
How soon will I see the results?

Barr: You'll see results in the first two weeks or so. But there can be swelling, hardness and lumpiness in that time. They resolve in three to six months. To improve results, we recommend our patients massage the area four times a day with moisturizing cream and spend time in Whirlpools.


Will this get rid of cellulite?

Barr: No. And that's a problem because cellulite is a disturbance of the surface attachment of muscle, skin and fat. Sometimes liposuction can worsen those areas.
How many days of work will I miss?

Gaynor: A liposuction on the stomach, you could go to work in the next two or three days. A full body, five to six days.


What will I feel like that day? That week?

Gaynor: It hurts like crazy. It feels like you've won the Marines sit-up contest. But we can give you medication, then you're just uncomfortable.
Will the fat return?

Barr: The liposuction will remove fat cells permanently, but the existing cells will swell with weight gain. You may gain it first in other areas, but you will eventually gain in those areas.
What are the risks?

Barr: Bleeding, infection, scarring, irregularities of contour, swelling of the extremities, asymmetries. With the ultrasonic liposuction you've got to add in there burn wounds.
How many mortgage payments will I have to skip to pay for this?

Barr: It really depends on how you're doing the procedure - office versus in-patient. It's really variable. Fees are not in general major expenses - from $500 to several thousand dollars.

Copyright 1999 Palm Beach Newspapers, Inc.