The most common location to perform liposuction in both men and women is the abdominal area. Abdominal liposuction likely makes more than half of all fat aspiration procedures. This is because this is the one area where everyone, regardless of age or sex, will accumulate fat first. This is biologically understandable as this is the largest surface area depot site on the body so it is ‘fat-friendly’.
But when one thinks of abdominal contouring, you must think three-dimensional and not just two-dimensional. The abdomen can not be just viewed as a flat surface. It is a curved surface that blends into the side of the waistline and into the back. Better abdominal and waistline shape ideally comes from treating the abdomen with a 270 degree approach. This means the liposuction must be carried back along the waistline into the flank and sometimes into the mid-back area. In essence, patients wants a more narrow looking trunk and waistline area, not just a flatter front only.
This is why in my Indianapolis plastic surgery practice, I almost always perform abdominal and flank liposuction as a composite unit. How the abdomen blends into the back is important for creating a better silhouette and in changing how clothes will fit.
Given the large surface area that can be treated, I find that Smartlipo (laser liposuction) has several advantages over traditional fat suction removal. First, there has been a clear trend towards less pain with the laser. Why that exactly occurs is not clear. It may be the effect of the heat on the nerve endings causing more profound temporary numbness or the sealing of the nerve ends from the heat. Either way, it is unequivocally clear that areas treated with Smartlipo have less pain after. Similarly, there is less bruising for sure. The reason for that is more obvious…cauterization and sealing of blood vessels. While there is less bruising, the same can not be said for swelling. Swelling is just as significant as with traditional liposuction and may be even a little more in the first few weeks after surgery.
While many can debate whether Smartlipo produces superior fat removal, my experience will not contest that in the abdominal and waistline areas. I have consistently observed better results and happier patients. My explanation would be the more thorough process that one undergoes in the operating room. Smartlipo is a two-phase extraction procedure that does take more time. The area is first treated with the laser and then aspirated. Thus, the treated area gets treated twice by two different methods. There is also the benefit of the several month process where fat that is not extracted will atrophy and shrink secondary to the collateral damage of the heating process.
Lastly, Smartlipo does tighten skin and this is most evident in the abdominal area. But it is not the amount of skin tightening that patients envision. It will not avoid a tummy tuck nor deal with tightening inches of loose skin. The effect is most evident by the decreased mobility of the skin surface as one runs their hand over it. It can also be appreciated when one bends over and the abdominal skin has less laxity and hang.
Dr. Barry Eppley
Indianapolis, Indiana