Liposuction is a great way to reduce localized areas of excess adiposity but it is not always the answer!
Ten common misconceptions about liposuction
Liposuction is one of the most frequently performed cosmetic surgical procedures in the United States and around the world. This is somewhat surprising, considering how many misunderstandings about it persist. Listed below are the ten most common liposuction misconceptions we hear as plastic surgeons, and what the actual facts are.
Liposuction can help you lose weight
The reality is that most patients only lose about two to five pounds in total. The best candidates, in fact, are generally within 30 percent of a healthy weight range and have localized fat pockets they would like to reduce.
Liposuction can treat cellulite
Cellulite is not simply an irregular pocket of fat – it occurs when subcutaneous fat pushes connective tissue bands beneath the skin, causing those characteristic dimples and bumps. Because liposuction is only able to remove soft, fatty tissue (and does not directly affect the skin or other tissues), the fibrous connecting bands causing cellulite are not altered.
Liposuction is not for “older” people
Any patient who is in good health and has had a positive medical examination may safely receive liposuction. A lack of firmness and elasticity (both of which commonly decrease with age) may compromise the skin’s ability to re-drape over newly slimmed, reshaped contours. Poor skin quality is one of the main contraindications to liposuction.
Liposuction is dangerous
While every surgery carries an element of risk, liposuction techniques have become increasingly sophisticated. If performed by an experienced and board-certified plastic surgeon, and if the patient follows all appropriate postsurgical instructions, liposuction can be as safe and successful as any other surgical procedure.
Liposuction will fix lax skin
The appearance of a double chin or a heavy tummy may involve some degree of sagging skin with reduced elasticity, as well as excess fat. In such cases, your surgeon may recommend a skin tightening procedure instead of (or in conjunction with) liposuction, as liposuction alone may result in a deflated appearance.
Fat deposits removed will return after liposuction
Liposuction is “permanent,” in that once the fat cells are suctioned out, they will not grow back. However, there will still be some remaining fat cells that can grow in size and expand the area if one’s calorie intact is excessive. The best way to prevent this is to maintain a healthy diet and exercise regimen.
Liposuction is the “easy way out”
As mentioned earlier, liposuction is not a weight loss method, and maintaining ideal postsurgical results should include a general commitment to a healthy lifestyle. Liposuction (or any other body contouring method, for that matter) is targeted to streamline and contour localized areas – ideally, in someone who is within a healthy weight range.
You can get back to your routine right after liposuction
While relatively safe and frequently performed on an outpatient basis, every surgical procedure entails a recovery period, and liposuction is no exception. The most common after-effects include swelling, bruising, and soreness at and around the treatment areas. While the healing process varies from patient to patient, most should plan to take at least a week off work to rest and recover. It may be four to six weeks before a patient can resume strenuous activity or exercise.
Liposuction is only for women
Men frequently request liposuction – in fact, it was one of the top five most popular cosmetic surgeries American men received this past year, according to ASPS statistics. Common areas for treatment include the abdomen, love handles and chest.
Liposuction is always the answer to belly fat
Liposuction targets only subcutaneous fat – the kind that is located below the skin and above the muscle. An abdomen that protrudes due to fat under the muscle and around the internal organs (known as visceral or intra-abdominal fat) will not be improved with liposuction. Appropriate exercise and diet are the only effective methods to combat visceral fat.
This has been in the news recently and may be of interest to my patients.
Does nonsurgical fat removal work?
Each year, over 150,000 people get nonsurgical fat removal performed – and not just women. Nearly 30,000 of those fat removal patients are men. Nonsurgical fat removal is a less invasive alternative to “regular”liposuction, but does it work? The answer is more complex than a simple yes or no.
How does it compare to regular liposuction?
Nonsurgical fat removal is also often called “nonsurgical” liposuction, but really, it isn’t liposuction at all. Traditional liposuction is a surgical procedure, involving small incisions in which a tube is inserted into a fatty area. The fat is then “sucked out” through the tube, resulting in the permanent removal of those fat cells. Liposuction can be used on large areas where there are significant fat deposits and may be effective after just one procedure. Since liposuction is a surgery, there is some recovery time with swelling, pain and a risk of infection.
Nonsurgical liposuction can be one of a number of procedures which use lasers, heat, cooling or sound waves to “destroy” fat cells which will the be removed from the body as metabolic products. Nonsurgical liposuction generally has less-to-no recovery time as surgical liposuction but it isn’t effective on large areas of fat. Its use should be limited to small, stubborn areas that remain after an adequate diet and exercise program or to patients who cannot undergo surgery. In order to be fully effective, multiple treatments may be required.
Types of nonsurgical fat reduction
Nonsurgical fat removal is done in the plastic surgeon’s clinic, using one of a number of proprietary or “brand name” procedures. Brand names like Exilis, i-Lipo, Liposonix and Zeltiq or CoolSculpting, each uses a different type of treatment which may be laser- or light-assisted, cryo or freezing therapy, or sound through ultrasound or radiofrequency. Each type works to destroy the cell membranes surrounding fat cells which over time, may appear to “melt” the fat away.
Pros and cons of nonsurgical fat reduction
Pros: Nonsurgical fat reduction is just what it says, nonsurgical. There are no incisions done which means a noninvasive procedure with less recovery time required, less swelling and pain and a greatly reduced chance of post-procedure complications such as infection. It doesn’t usually require a lot of pre-procedure preparation and can often be done during the day with a quick return to normal activities.
Cons: The actual fat reduction takes place over the course of weeks or months and several treatments may be required. Because nonsurgical liposuction is an external treatment, it can be more difficult to target the fat in question. The surgeon may not be able to optimally address the fat in difficult areas or in patients with a good deal of scar tissue. Targeting may also be tricky as the physician cannot immediately “see” where fat destruction has been effective and must wait for additional treatment periods to refine the effects. Nonsurgical fat reduction does not produce immediately dramatic results and is not effective in people who need large sections of fat removed.
The bottom line on nonsurgical fat reduction
Liposuction, under expert guidance, is highly effective, more accurate and can be used in a variety of conditions. Newer ultrasound-assisted procedures have enabled plastic surgeons to be highly accurate in fat removal with a minimum of post-surgical complications. In general, liposuction is considered to be much more effective, but nonsurgical fat removal can be a good alternative for those who simply need a little additional help for some stubborn spots – or can be the only alternative if surgery is not possible. So, yes, nonsurgical fat removal works for the right patient but it does not compare to traditional liposuction. Noninvasive alternatives to fat removal, of course, bring limited results, so it’s important to discuss with your surgeon what the true body contour changes will be, as opposed to expectations from ads. In the end, the search for the Holy Grail of noninvasive body sculpting continues!
If you’re a smoker considering cosmetic surgery, your plastic surgeon will likely require you to stop smoking for at least two weeks before your procedure ( I actually sometimes ask my patients to quit for up to 3 months in advance if they are heavy smokers–D. Medalie). A long-term follow-up study finds that many patients receiving these instructions will quit smoking, or at least smoke less, in the years after cosmetic surgery, reports the September issue of Plastic and Reconstructive Surgery®, the official medical journal of theAmerican Society of Plastic Surgeons (ASPS).
“Our results show an association between cosmetic surgery and smoking cessation at long-term follow-up,” said lead author Aaron C. Van Slyke, MD, MSc, of University of British Columbia, Vancouver. “Surgeons who request preoperative smoking cessation may influence patients’ long-term smoking status.”
Many Cosmetic Surgery Patients Quit or Reduce Smoking
The follow-up study included 85 patients who were smokers when evaluated for cosmetic surgery. Like most plastic surgeons, senior author Nicholas J. Carr, MD, required all patients from his cosmetic surgery practice to refrain from smoking for at least two weeks before elective procedures. Those instructions reflect a well-demonstrated increase in wound healing problems and other negative outcomes among smokers after plastic surgery.
Five years after cosmetic surgery, 47 patients responded to a follow-up survey. Most of the patients were women; the average age was 40 years. The most common procedures were tummy tuck (abdominoplasty), breast lift (mastopexy), and facelift. After exclusion of five social smokers, the study included 42 patients who were daily smokers before cosmetic surgery.
In the follow-up survey, about 40 percent of patients said they no longer smoked cigarettes on a daily basis. Nearly one-fourth had not smoked at all since their cosmetic surgery procedure.
Most patients said they had reduced their cigarette use by any amount. Seventy percent agreed that discussing their increased surgical risks with the plastic surgeon influenced their ability to quit or reduce smoking.
However, one-half of patients admitted they did not follow the instructions to refrain from cigarette use before surgery. Nearly one-fourth continued to smoke up to the day of their procedure. Dr. Van Slyke and colleagues did not test to confirm whether patients had stopped smoking.
The complication rate after cosmetic surgery was higher in patients who continued to smoke: 24 percent versus 14 percent. (The difference was not statistically significant.) More serious wound-healing complications occurred in two patients, both of whom did not follow the instructions to stop smoking.
Due to the negative effects of smoking on wound healing, many plastic surgeons are unwilling to perform cosmetic surgery procedures in patients who smoke. Compared to studies in other groups, the new findings suggest that cosmetic surgery patients seem more likely to quit or cut back on smoking at long-term follow-up.
“This is consistent with previous research showing patients who seek to obtain cosmetic surgery are more motivated to sustain positive lifestyle changes,” Dr. Van Slyke said.
The results suggest that patients were more motivated to quit by targeted messaging with specific examples of the negative effects of smoking, rather than by a description of the general health benefits of smoking cessation. The authors conclude, “The dialogue between plastic surgeon and patient during the cosmetic surgery consultation serves as a unique moment to provide targeted smoking cessation counseling that may persist well beyond the surgical interaction.”
Dr Medalie is pleased to announce that once again he has been elected one of America’s top doctors. He is proud to serve Cleveland and Ohio as a premier plastic surgeon and will continue to strive for best results for his Cleveland plastic surgery patients.
Dr. Medalie of Cleveland Plastic Surgery is happy to announce that he has been selected for the 2013 Best of Cleveland Awards for Plastic Surgeons. He is proud to serve his community and will continue to strive for the optimal outcomes for all of his patients.
Dr. Medalie of Cleveland Plastic Surgery and Metrohealth medical center is pleased to announce that he has been given the “most compassionate doctor” award. Through multiple patient reviews he has been elected to this honor. He is gratified to have received this award and will continue to serve his Cleveland, Ohio patients and patients from all parts of the country with the utmost dedication, expertise and compassion.
It is with great pleasure that I announce my election again to Castle Connolly’s list of top doctors in America. I am proud to perform plastic surgery on my patients from Cleveland, the state of Ohio and all neighboring states. I encourage any interested patients to contact me through this web site for more information about cosmetic and reconstructive plastic surgery.
Dr. Daniel Medalie is recognized among Castle Connolly’s Top Doctors® for Cleveland, OH region in 2013.
A Cleveland, OH Board Certified physician specializing in Plastic Surgery, Dr. Daniel Medalie, is a Castle Connolly Top Doctor for 2013.
Cleveland, OH (PR Newswire) May 20, 2013 – Castle Connolly Medical Ltd., America’s trusted source for identifying Top Doctors, has selected Cleveland’s Plastic Surgery specialist Dr. Daniel Medalie for inclusion in its highly selective list of Regional Top Doctors this year.
Castle Connolly Medical Ltd. publishes its list of Castle Connolly Top Doctors® at www.castleconnolly.com, as well as in a wide variety of printed directories, partner publications and on partner/affiliate websites including US News and World Report’s annually updated list of “Top Doctors.” All told, fewer than 35,000 physicians – less than 5% of the nation’s licensed physicians – have been selected as Castle Connolly Top Doctors in their regions for their specialties.
Castle Connolly Top Doctors® are selected by Castle Connolly Medical Ltd. after being nominated by peer physicians in an online nomination process. Nominations are open to all board certified MDs and DOs and each year tens of thousands of doctors cast many tens of thousands of nominations. Honorees are selected from the nominees by the Castle Connolly physician-led research team based on criteria including their medical education, training, hospital appointments, disciplinary histories and more.
For more information on this Castle Connolly Top Doctor, please visit Daniel Medalie’s profile on www.castleconnolly.com.
Castle Connolly Medical Ltd.’s President and CEO Dr. John Connolly has this to say about Dr. Medalie’s recognition: “Only a small percent of physicians are selected to be Castle Connolly Top Doctors. Our goal is to make it easier for an average person to find the right doctor for them in what can be an overwhelming process at a difficult time in a person’s life. Dr. Medalie was nominated by Board Certified peers and selected by our research team at Castle Connolly Medical Ltd. Selection is an impressive accomplishment worthy of recognition. My congratulations to Dr. Medalie.”
To find out more or to contact Dr. Daniel Medalie of Cleveland, OH, please call 216-778-4450. or visit www. ClevelandPlasticSurgery.com
Castle Connolly Medical Ltd. identifies top doctors in America and provides consumers with detailed information about their education, training and special expertise in printed guides and online directories. It is important to note that doctors do not and cannot pay to be included in any Castle Connolly guide or online directory. Learn more at www.castleconnolly.com.
American Registry, LLC, recognizes excellence in top businesses and professionals. For more information, search The Registry™ at https://www.americanregistry.com..
Patients Honor Dr. Daniel Medalie for Compassion
Dr. Daniel Medalie of Cleveland, OH is ranked among the top physicians in the nation based on patient reviews.
Cleveland, OH (PR Newswire) month] 11, 2013 – Patients’ Choice has announced that Dr. Daniel Medalie was one of a select few physicians honored with the prestigious 2012 Compassionate Doctor Certification.
Each year, nearly 100 million patients across the U.S. access websites like Vitals, UCompareHealthCare, and Patients’ Choice to provide feedback about experiences with their physicians.
Only those physicians with near perfect overall and bedside manner scores, as voted by their patients, are selected for the Compassionate Doctor recognition. Of the nation’s 870,000 active physicians, only 3% were accorded this honor in 2012.
The Compassionate Doctor certification is part of the Patients’ Choice recognition program, where patients rate and vote for their favorite doctors.
Dr. Daniel Medalie commented on the recognition: “This is quite an honor for me. I am very pleased to have been selected and grateful to my patients who went out of their way to rate me and give me positive reviews.”
For more information on this Compassionate Doctor, please visit Dr. Daniel Medalie’s profile on Vitals.com.
Following the publication of Dr. Daniel Medalie’s selection for the Patients’ Choice Award, American Registry seconded the honor and added Dr. Medalie to The Registry™ of Business Excellence. An exclusive recognition plaque has been designed to commemorate the honor. The doctor’s custom wall plaque is shown here.
For more information on Dr. Daniel Medalie, located in Cleveland, OH call 216-778-4450. or visit www.ClevelandPlasticSurgery.com
This press release was written by American Registry, LLC with approval by and/or contributions from Dr. Medalie and was distributed by PR Newswire, a subsidiary of UBM plc.
Patients’ Choice provides in depth information on doctors in your area who have been recognized and awarded for outstanding patient care and expertise. The Compassionate Doctor certification is the honor role of physicians who have received the highest overall and bedside manner ratings by their patients. American Registry, LLC, recognizes excellence in top businesses and professionals. The Registry™ includes over 2 million significant business and professional recognitions. For more information, search The Registry at https://www.americanregistry.com.
Contact Information:
Dr. Daniel Medalie
Phone: 216-778-4450
Website: www.ClevelandPlasticSurgery.com
Dr. Daniel Medalie Selected For “Compassionate Doctor Award 2012.” Source: American Registry and Patients’ Choice on behalf of Dr. Daniel Medalie
New Survey: Women Want to See Breast Reconstruction Results Before Cancer Surgery
A new survey released today by the American Society of Plastic Surgeons (ASPS) shows 89 percent of women want to see what breast reconstruction surgery results would look like before undergoing treatment for breast cancer,* prompting the world’s largest group of board-certified plastic surgeons to launch a landmark show-and-tell event as part of Breast Reconstruction Awareness (BRA) Day USA, October 17, 2012 in New Orleans.
Liposuction is one of the most frequently performed cosmetic surgical procedures in the United States and around the world. This is somewhat surprising, considering how many misunderstandings about it persist. Listed below are the ten most common liposuction misconceptions we hear as plastic surgeons, and what the actual facts are.
Each year, over 150,000 people get 
