Orange County, Santa Ana, Newport Beach

A friend of mine once said “Physicians are just nerds trying to be cool.”  The title above is my feeble attempt to sound hip!

But joking aside, when a patient presents to me for improvement of the abdominal area, the question arises which procedure is best: liposuction or tummy tuck (abdominoplasty)?

If a patient has no stretch marks or loose skin and the only issue is excess fat under the skin, the decision is easy:   liposuction will remove excess fat and since the patient has normal skin tone and elasticity, the skin will retract properly.  If on the other hand, the patient has hanging skin over the pubic area and a hanging shelf of skin above the umbilicus (belly button), then a tummy tuck will give the best result.

What about the patient who is borderline though?  There are patients who have borderline skin elasticity, may or may not have some stretch marks and are in that gray area between liposuction and tummy tuck.  This is where patient’s concerns and expectations are important to asses.

First of all, is the patient terrified of having general anesthesia, despite the safety of general anesthesia in healthy individuals?  In a recent article by the American Society of Plastic Surgeons, the risk of death from elective out patient surgery was 1:50,000 versus 1:5,000 from driving.  This means the risk of dying while driving is TEN times more than having elective outpatient surgery!  Are they concerned about the increased incisions and recovery time after a tummy tuck?  Is cost a factor?  What are the patient’s expectations?  Is he/she expecting a flat stomach with little or no stretch marks or is the patient looking for some improvement only?  It is critical the patient is honest with him/herself and with the surgeon, and adequately addresses their concerns and expectations.  Liposuction is a very effective procedure for patients who have borderline skin tone, as long as the above issues are adequately addressed.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

As an Orange County liposuction surgeon, many patients ask about the recovery period.

Depending on the patient, the area and amount of liposuction required, the procedure may be performed in the office under local anesthesia.  In other cases, the procedure is performed in an outpatient surgery center using general anesthesia.

After liposuction, the patient wears his/her compression garment, depending on the area of procedure.  For the abdomen, a binder is used.  For the inner and outer thigh, a “biker” type garment is worn.  Other areas have their own type of garment.  The purpose of the garment is to minimize swelling, and to allow the skin to retract properly to the underlying tissue.

The patient is seen 24-48 hours after surgery.  The areas are inspected to make sure there is no bleeding or infection and that the compression garments are fitting properly.

The next visit is one week after surgery.  At this visit, the sutures (if placed) are removed.  At this time there may be bruising in some or all areas of liposuction, which will resolve in the next few weeks.  There will also be swelling.  It is important for the patient to realize during the first three months it will difficult to asses the final result due to swelling.  The final shape realistically begins after three months.  The patient is instructed to continue wearing the garment and to avoid any exercise or activity which will move the area of liposuction.

The patient returns for his/her one month follow-up.  If the healing process is proceeding normally, the patient may start exercising.  The garment may or may not be worn at this time.

At the three month follow-up, the swelling has improved dramatically and the final contour is beginning to show.  In some patients, the swelling may take longer to resolve.

The six month follow-up has arrived!  By this time, the swelling is resolved and the final shape has been reached.  It is very common to have areas of numbness where liposuction was performed.  The numbness may take up to one year or longer to completely resolve.

Liposuction typically removes 85% of fat cells from the area.  This means out of every 100 fat cells, 15 remain.  Therefore, liposuction is not a substitute for proper diet and exercise.

This is a typical recovery for a patient undergoing liposuction surgery.  Not every one will have the same experience and, rarely, complications do occur.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

Mommy makeover is the catch phrase for cosmetic surgery involving the breast and abdomen, the two areas most commonly affected by pregnancy.

The breasts typically “deflate” after pregnancy and breast feeding and almost always will require a breast augmentation to regain the lost volume.  If there is sagging of the nipple and loose skin, a breast lift (mastopexy) may be needed as well.

Some patients (the lucky ones!) have little effect on their stomach area after pregnancy.  However, most patients will develop loose skin, stretch marks and weakness of the abdominal muscles, resulting in a “beer belly” appearance.  Typically a standard or extended abdominoplasty is required, although some patients can achieve an excellent result with a mini-tummy tuck.

In most cases, both breast and abdominal surgery can be performed together, if the anesthesia time can be kept under six hours (this is the recommended time limit for outpatient elective surgery by the American Board of Plastic Surgery).  Performing both surgeries together has the benefit of one recovery term (this is especially critical for patients who work) and lower cost.

Mommy makeover surgery is amongst the most expensive cosmetic surgery procedures performed.   This is due to the prolonged surgery and anesthesia/operating room time required to adequately address and correct the changes discussed previously.  Whether the time and cost is worth it is a personal question only the patient can answer.  However, if you have realistic expectations and are doing the procedure for YOU and YOU ONLY, it is one of the most rewarding surgeries I perform.  Imagine reversing the effects of pregnancy, what a wonderful concept!  Many patients have told me their sex life has improved since the surgery because they feel more confident about themselves.  The smile on the partner’s lips is always a big give-away!

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

Santa Ana, Orange County, Riverside County

Liposuction, also known as liposculpture, is one of the most common cosmetic procedures performed in the United States.  Many of my Orange County patients request liposuction as a separate or combined procedure.

Liposuction literally means sucking out the fat and, in fact, this is what is done.  Small stab incisions are made close to the area being treated, and a solution containing numbing medication and a vasoconstrictor is injected in the area.  The purpose of the vasoconstrictor is to constrict the blood vessels and thus result in less bleeding and bruising.  After several minutes, the fat is suctioned out with a special cannula.  The cannula is blunt at the end and has 2-3 holes just proximal to its end.  The cannula is attached, via special tubing, to a suction machine.  As the cannula is moved back and forth, the fat is aspirated.  It is by feel of the hand and experience which allows the surgeon to contour the area appropriately.

There are several liposuction techniques available.  Ultrasonic liposuction uses a special cannula without holes which uses ultrasonic vibration to “melt” the fat.  The fat still needs to be aspirated with traditional cannulas and technique.  Laser assisted liposuction, also known as Smart Lipo, involves using a laser to promote tightening of the area underneath the skin and thus, theoretically, promote faster healing and less bruising.  Again, traditional liposuction cannula and technique is required to aspirate the fat.  Which technique is better?  I always tell my patients to look at before and after photos of surgeons using each technique.  It is ultimately the experience and artistic eye of the surgeon which determines the final result.  A poorly focused, poorly exposed photo of an uninteresting object is not going to look any better if taken with an $8000 top of the line digital camera than a $200 basic camera.  In other words, it is not the camera which takes a great picture, it is the photographer.

The good news with liposuction is that approximately 85% of fat cells are removed from the area treated.  However, if one is not careful with their weight, other areas of the body, and eventually the area treated, will gain the volume of fat back.

Ideal patients for liposuction are at or near ideal body weight, with areas of fat deposits which are genetically resistant to diet and exercise.  In women, these areas are typically the inner and outer thighs.  In men, the love handles are the usual culprit.  However, liposuction can safely be done in other areas as well.  Other common areas include the abdomen, back, neck, and arms.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in central Orange County.  If you like to schedule a complimentary consultation, please call 714-834-0101.

The current technique involves making small stab incisions next to the area of liposuction and infiltrating a solution containing salt water, local pain medication (xylocaine) and epinephrine.  The purpose of the solution is to blow up the fat for easier removal, pain control and to minimize bruising and bleeding (due to the epinephrine).  The fat is then aspirated with specialized instruments designed specifically for this procedure.

Although fat can be removed from any patient, the ideal candidate is at or near their ideal body weight and has localized areas of fat collection which are resistant to diet and exercise.

Studies have shown liposuction can remove as much as 85% of fat cells, which means out of every 100 fat cells, 15 remain in the body.  Liposuction, therefore, is not a substitute for continued diet and exercise.  With weight gain, the remaining fat cells will become enlarged, off-setting the final result. 

The most common areas for liposuction are the neck, male breast (gynecomastia), abdomen, flanks (love handles), inner and outer thighs, and inner knees.

Currently, newer procedures are being marketed as an alternative to liposuction.  These include mesotherapy and laser-assisted liposuction (Smart Lipo).  These techniques have not been proven as safe, effective or reproducible as traditional liposuction.  I have provided the links from American Society of Plastic Surgery regarding these procedures.  Please click for link to mesotherapy and to Smart Lipo.  Since these techniques currently are not endorsed, I do not perform them.

I have attached before and after photos to illustrate the effectiveness of this procedure.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon and member of American Society of Plastic Surgeons.  His office is centrally located in Orange County, in the city of Santa Ana.
To schedule a complimentary consultation, please call 714-834-0101.