We’d be liars if said the thought of a little nip/tuck hadn’t crossed our minds once in a while, especially coming off of an indulgent holiday season when our pants are fitting a wee bit tighter. It’s not a decision to be made lightly, though, and it definitely merits proper vetting of the plastic surgeon who will be performing the procedure. Additionally, it’s imperative that you’re getting the right kind of liposuction for your body as there are different types — and there’s not a one-type-fits-all solution.

“Liposuction produces fantastic results in the properly selected patient, but it needs to be performed by a qualified, board-certified surgeon who knows the technology, who can properly identify the best procedure for you and who operates safely,” says University Plastic Surgeons’ Dr. Roberto Lachica. “Because there’s not just liposuction — there’s SAL, UAL, HD Lipo, ThermiTight — a full spectrum of treatments.”

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University Plastic Surgeons’ Dr. Roberto Lachica has been in practice for 19 years, is certified by the American Board of Plastic Surgery and is a Memphis Magazine and Castle-Connolly Top Plastic Surgeon.

Liposuction, the process of suctioning fat out of the space underneath the skin with the goal of changing the outer contour of a particular part of the body, is perhaps the most commonly performed and least invasive of the true plastic surgical procedures, but it is not without risks.

“Liposuction can entail different degrees of treatment,” says Dr. Lachica. “For the larger treatment areas, this is real surgery under general anesthesia with real benefits and also real risks.”

So, how do you get started? First things first: Pick a plastic surgeon actively certified by the American Board of Plastic Surgery. In the hands of a poorly qualified individual who doesn’t understand the technology or have adequate surgical training, liposuction devices can cause third-degree burns, extreme skin dimpling or worse. “It’s all about safety, and that is why the typical board-certified plastic surgeon trains for 6, 8, maybe even 9 or 10 years. My colleague Dr. Wallace has been in the game 26 years; I’ve been in it for nearly 20 years,” says Dr. Lachica.

Beyond delivering expertly executed procedures, an experienced, board-certified plastic surgeon can also deliver something that is invaluable: Truth.

“A good plastic surgeon has good judgment and is able to make recommendations that are best for the patient, because they know the intricacies of different procedures,” says Dr. Lachica. “You do as much for a patient by telling them that they are not a candidate for a procedure as you do when you tell them they are a candidate for an operation.”

Keeping all of the above in mind, let’s get to it. Below are the main types of liposuction along with Dr. Lachica’s expert insight on what to expect from each.

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Beyond delivering expertly executed procedures, an experienced, board-certified plastic surgeon can also deliver something that is invaluable: Truth.

4 MAIN TYPES OF LIPOSUCTION

Suction-Assisted Lipectomy (SAL)

SAL is what people traditionally understand to be liposuction, which is a procedure to suction fat in the operating room under general anesthesia.

IDEAL CANDIDATE: An ideal candidate for SAL is an overall healthy patient who is not obese, or minimally obese, who has excess fat in specific areas like the hips, thighs or flanks. “There’s a finite amount of fat that you can suction safely from the body before you start to have medical complications like bleeding, blood clotting or fluid in the lung,” says Dr. Lachica. So, if you are a young, healthy woman with specific areas of fat excess — not a large amount of fat — and no previous surgery, Dr. Lachica says the SAL is the way to go.

RECOVERY TIME: After surgery, the patient — as is the case with almost all lipo patients — is placed in a compression girdle to hold the skin in place, so it heals evenly with a minimal amount of swelling, bruising or dimpling. The recovery turns out to be pretty swift, about a week of downtime. “If we did it on a Friday, the patient could be up and walking the next day, they could be resuming a normal daily activity by Monday, and they could return to work by mid-week, provided they don’t do something crazy like running 10 miles,” says Dr. Lachica.

GENERAL COST: Approx. $2,500 per area + surgery center fee + anesthesia fee = Approx. $5,000

Ultrasound-Assisted Lipectomy (UAL)

UAL is the application of ultrasound heat energy to melt the fat prior to suctioning. “UAL is slightly more invasive in that you are using a larger probe and delivering heat energy prior to suctioning, so there is an increased level of risk in terms of thermal damage,” says Dr. Lachica, explaining that the surgeon has to be more careful with the technology for UAL, because the device can cause burning by delivering too much heat. The UAL adds technology costs (through the expensive UAL device) and the surgeon’s additional time and skill to the operation, upping the price tag a bit. “When we recommend UAL, it is for a very specific patient whom we feel will strongly benefit from it, because that is the best technology we can offer to provide the best results in those unique cases,” says Dr. Lachica.

IDEAL CANDIDATE: UAL is optimal for areas such as the back, which has very thick, fibrous, dense fat that is more amenable to melting prior to suctioning, as well as for patients who have had liposuction before and need repeat liposuction. Males are also excellent candidates for UAL, because they have very dense, fibrous fat. It also great for those with Gynecomastia, an abnormal enlargement of breast tissue in the male.

RECOVERY TIME: The perceived recovery of the UAL is actually a little better than the SAL, because the skin contracts and shrinks down over the new contour. “Many patients feel that the recovery is enhanced in some ways with the UAL, because the skin shrinks down and there is potentially less swelling because you’ve had the heat energy in there,” says Dr. Lachica. Again, you could be back to work in a matter of days.

GENERAL COST: Approx. $2,500 + surgery center fee + anesthesia fee + UAL device surcharge + added time = Approx. $6,000

HD Liposuction

“HD Liposuction is our newest method of liposuction, which is an in-office procedure done with local anesthesia or monitored sedation. It is a way to quickly and effectively perform liposuction with a high-frequency oscillating device that makes the procedure more comfortable and more tolerable while the patient is awake and not under general anesthesia,” says Dr. Lachica. Obviously, this has become a popular way to have liposuction done free of the cost of general anesthesia or an operating room fee. It’s also a lot cheaper, because it is performed on smaller areas.

“In our office, we have a dedicated HD Lipo Suite where the machine is set up; it’s essentially a mini, in-office operating room,” says Dr. Lachica. “And we now offer an option of having an anesthesiologist to provide sedation. So it is the best of both worlds. You will get sedation, so you are comfortable, and the benefit of not having to pay for the costly off-site operating room.”

IDEAL CANDIDATE: Someone who needs a small area treated and who can tolerate surgery without general anesthesia

RECOVERY TIME: “You can be doing near-normal activities of living the next day, exercising within two to three days and back at work the following week,” says Dr. Lachica, noting that all of these patients get a compression garment, which controls swelling and provides support and comfort, so they are able to function pretty well.

GENERAL COST: Approx. $1,500 to $2,500

ThermiTight®

The ThermiTight® is a small heated probe that is placed under the skin to precisely melt fat and tighten the skin without actually having to actually suction the fat out. It is the least invasive, quickest procedure. Most commonly, it is used to contour the underside of the chin and jaw, and sometimes the abdomen for mild cases of fat excess. “The downside of awake liposuction is that there is some level of discomfort, and that is why we only do very small, selective fat pockets,” says Dr. Lachica. “We find that for these small areas, this less invasive, less complicated procedure does a fine job. You’re able to modulate the fat and the skin and get a good result with minimum downtime, minimum risk, no anesthesia and no trip to the surgery center. So for the properly selected patient, it’s actually a very nice alternative.”

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A real-life before and after of a ThermiTight® patient

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A real-life before and after of a ThermiTight® patient

IDEAL CANDIDATE: The ThermiTight® is for patients with selective fat pockets under the chin or jaw and small pockets of fat in the abdomen, thighs or flanks — very small treatment areas — in patients with healthy, tight skin, few wrinkles and no sagging.

RECOVERY TIME: A couple of days, during which time a light elastic compression garment is placed on the face

GENERAL COST: Approx. $1,000 to $1,500

Whether you want a quick ThermiTight® procedure or require a more complex SAL or UAL, the name of the game is picking a qualified, well-trained surgeon — one who can truthfully tell you which procedure is best for you and describe clearly what the expected results would be.

“A good surgeon is somebody who can first determine if a patient is ideal for liposuction, offer it as a primary procedure or combined with a tummy tuck and perform the surgery to achieve excellent results with minimal risk,” says Dr. Lachica.

University Plastic Surgeons is located at 1068 Cresthaven Road, Ste. 500, Memphis, TN, 38119. Hours are Monday through Friday, 9 a.m. to 5 p.m. For more information or to schedule a consultation, call (901) 866-8525 or visit utuniversityplasticsurgeons.com.

This article is sponsored by University Plastic Surgeons.