The gold standard with the American Board of Plastic Surgery for liposculpture is the use of tumescent technique.  Tumescent liposuction is associated with three components.  Number one is the tumescent fluid of lactated ringer or sodium chloride.  This fluid is used to infiltrate into the fat specifically, hydrating the fat and allowing the contouring of the specific body part with reduction of contour surface irregularities and deformities.  The second component is Lidocaine.  Lidocaine is a numbing agent.  Lidocaine allows for up to 24 hours of pain relief and is very useful for tumescent technique liposculpture.  Finally, epinephrine, which is added in order reduce bruising and bleeding, as well as allows for vasoconstriction of the arterial blood vessels and thereby allowing for a great reduction of bruising in the postoperative period.  Postoperative compression garments should be included at 6 to 8 weeks of girdles and abdominal binders to reduce the swelling as well as to allow for a confluent smoothing effect of the abdomen, hips, flanks and inner and outer thighs.

The picture here describes preoperatively a patient with significant lipodystrophy of the iliac crest roll hips, periumbilical lower abdomen, as well as the interomedial and posterolateral saddlebags and the infragluteal fold banana rolls.  This patient underwent a 2 liter tumescent liposculpture procedure and is now six months postoperatively showing a nice contour softening of the inner and outer thighs, infragluteal fold as well as a reduction of the muffin top and hip area as well as the periumbilical fat.

The example to the left is a patient with significant lipodystrophy adiposity of the iliac crest rolls, the belt area, extending to the periumbilical and lower abdomen.  This patient is not an excellent candidate, but rather a good candidate for liposuction, as he does have significant intraperitoneal fat including omentum and mesentery.  However, liposuctioning the sides and the lower abdominal periumbilical area will help to reduce some of the lateral distention along the hip area and along the lower beltline.  The patient underwent tumescent liposculpture procedure.  Postop one week results show a great reduction in fat around the iliac crest roll and the hip region extending to the periumbilical lower abdominal area.  Liposculpture in men is quite different than in women in that the fat is fibrotic, usually thicker, and harder to get out within the subcutaneous Camper’s and Scarpa’s fascia.  These patients however do well with aggressive tumescent liposuction technique and six to eight weeks of compression garments postoperatively.

MICRO LIPOSUCTION

The above patient is a young 22-year-old female presenting with gynoid appearance, significant iliac crest roll hip fat as well as anteromedial, posterolateral and infragluteal fold fat.  The patient is an excellent candidate for tumescent liposuction using micro liposuction techniques with infiltration of tumescent fluid.  The patient underwent the procedure and this is her 8-week postoperative visit.  Notice the smoothing out nicely of the iliac crest rolls and the lower anteromedial thighs.  Notice also softening of the lateral thigh saddle bag areas with great reduction in size of the diameter of the thigh itself.  She has a more smooth even appearance of her upper, middle and lower third of her body.

Performing tumescent technique liposuction with Lidocaine, epinephrine and sodium chloride for wetting solution and small 2 and 3 mm cannulas in the bi-directional fashion of the iliac crest roll hip area as well as suctioning the deep localized fat of the inner and outer thigh and infragluteal banana roll area can lead to a very nice natural result with a tapering affect of the lower third to be evened out with the upper and midriff area.  This is a classic example of severe gynoid appearance, correctable by micro liposculpture tumescent technique.

This patient underwent tumescent liposculpture technique in a bidirectional fashion at the muffin top as seen on the “Dr. Oz Show” with Dr. Linder and Dr. Oz.  She also underwent infragluteal fold liposculpture in order to reduce the fat along the buttock area as with Dr. Linder on the show “The Doctors.” 

Note her after-photo at four weeks.  The iliac crest roll shows a beautiful, natural contour without contour irregularities or deformities and smoothing out of the hips.  She also has a nice cut along the infragluteal fold showing a nice lower buttock division to the upper posterior thigh.  This patient is wearing a compressive garment for four weeks and will continue for another four weeks.  Combined tumescent technique of the infragluteal fold and the iliac crest rolls can allow a patient to have a nice lower third proportionate sculpting procedure when performed under general anesthesia using the tumescent technique.

This patient had the 2 mm cannula used in order to directly break up through a pre-tunneling technique the scar tissue without the suction on and then 1 atmosphere of vacuum suction was applied to remove a small amount of fat in perpendicular direction and to smooth out and feather out the periumbilical area.  When considering revision liposculpturing, very small cannulas can be used in order to reduce further contour deformities at this time.

This patient is a 21-year-old female presenting with severe gynoid appearance, a pear-shaped appearance with a significant amount of lipodystrophy adiposity fat in the lateral saddle bag area and extending to the infragluteal fold.  This can be removed both along the inner and outer thigh through tumescent liposculpture technique and the iliac crest roll muffin top can be suctioned out in order to obtain a nice contour.  This is referred to as tumescent liposculpture under general anesthesia.  On this patient 1.25 liters of fat was removed after tumescent fluid was instilled. 

Postop Day One appearance with the patient in the sitting position shows nice smoothing out of the hips and narrowing of the inner and outer thigh, giving her much more proportionality with her upper and mid third.

Other consultations that day also included mommy makeover, including breast implant lift, tummy tuck and liposculpture of the hips.  These patients present to Beverly Hills from Las Vegas for surgery, including breast augmentation, breast revision, breast lift, breast reduction, liposculpture, and abdominoplasty.

Patients are presenting for cosmetic dentistry with Dr. Kevin Sands, a world recognized leader in cosmetic dentistry, including all forms of dental bonding, veneer and perfect smile dental work.  He has a multitude of celebrity clientele who have undergone his masterful artistry in perfect dental reconstruction and cosmetic perfection.  Patients are also presenting for facial rejuvenation surgery, including eyelids, rhinoplasty and dermal fillers. 

Dr. Robert Kotler is a facial cosmetic surgery specialist who performs absolute remarkable beautification and rejuvenation, creating a youthful appearance to the face through his eyelid surgery, brow lift and facelift procedures.  He is a world recognized leader in rhinoplasty and nasal surgery, creating the absolute perfection of proportionality of the nose to the specific woman’s facial structure.  Robert Kotler is considered a truly greater facial plastic surgeon with well over 35 years of experience and celebrity clientele from every major Hollywood studio. 

In a similar fashion, patients present for body sculpting, including breast enhancement, breast revision, breast reduction, breast lifting, tummy tucks and total body lipo-contouring, to us, Dr. Linder, Beverly Hills Body Sculptor.  The name Linder with the Dr. Linder Bra has become a “figure in the community,” consistency with body sculpting from patients of every walk of lift, from celebrities and patients of international travelers worldwide. 

The Beverly Hills Extreme Makeover includes complete body and facial transformations from worldwide leaders and experts, including cosmetic dentistry, Dr. Kevin Sands; facial plastic surgery and rejuvenation with Dr. Robert Kotler and total body mommy makeovers and extreme body sculpting, lipo-contouring with Dr. Stuart Linder.