Factors That Can Affect Fat Grafting Success in Brazilian Butt Lift

Fat grafting is the latest trend in body sculpting. A fat grafting procedure transfer autologous fat (from your own body) from areas in which patients have excess fat, such as arms, abs, flanks and back, and injects it into areas that may need volume-enhancement, such as face, hands, breasts or buttocks. In particular, many of my patients who desire a fuller, more curvaceous derriere opt for a buttocks augmentation with fat grafting (BBL). Since the fat grafted is not a foreign material such as an implant, there is no risk of rejection and very little risk of complications associated with implants such as often reported ruptures or leaks.

After the autologous fat is re-injected, 65% to 85% of the transferred fat will usually take and stay in the area for years to come, providing a permanent solution for the patient’s cosmetic needs. The rest of the transplanted fat will be harmlessly and naturally metabolized by the body.Due to this variable amount of fat graft take patients frequently require more than one session of grafting to attain their desired result. The percentage of the fat that survive will vary depending on many factors, some of which doctors can affect (the method of harvesting, processing and placement) and some others which are under patients’ control.

 The method of harvesting is among the factors that enhance survival of the transferred autologous fats, and surgeons can definitely influence it. Clinical studies have shown that fat transfer procedures success is dependent on factors during the removal of the fat, such as the aspiration pressure used, and the cannula’s size used. The area where the fat comes from per se is not a determinant factor in fat grafting attainment. In this respect, I favor VASER liposuction system for viable fat harvesting. Fat cells treated and removed during VASERlipo procedures are typically of high quality and are viable to re-introduce the body (1). The VASER lipo system was designed to maintain the integrity of fat cells, by using ultrasound energy to selectively target and dislodge fat cells from the fatty tissue matrix. Atraumatic VentX cannulas give you the ability to fine tune suction pressure to remove the treated fat. Typically, 2.9mm to 4.0mm precision cannulas are used, depending on the donor site, and the pressure utilized to extract the fat with VASERlipo system is minimal (around 15 inch Hg) as opposed to the standard 25 inch Hg, which can affect the viability of the fat cells harvested. Two recent, independents studies have confirmed the viability of fat removed with VASERlipo: Cytori Therapeutics conducted a multi-site study that confirmed the viability of VASER-treated fat at 85% and regenerative cells at 87%, and the University of Pittsburgh Medical Center found the viability of VASER-treated fat to be over 80%, six weeks post re-injection (2). Research concluded that breaking apart adipose tissue prior to aspiration allows the use of atraumatic cannula and lower vacuum levels, which prevent the fat from tearing or shearing during aspiration.  

Moreover, the method of processing is the second key factor that surgeons can use to maximize fat survival. The preparation process clears the donor fat of blood, pain killers and other unwanted elements that could cause infections or other undesirable complications. Separation from excess fluid (purification of the fat) ensures that the surgeon is injecting a higher proportion of fat. After the fat selection process is completed, only 500cc to 1500cc of the fat will be injected into each butt cheek. Three primary methods (sedimentation by gravity, filtering technique, and centrifugation) have been used clinically to process fat grafts. In this respect, centrifugation is the more effective method of choice for processing facts, based on numerous clinical studies that concluded: “although may be more aggressive on adipocytes, centrifugation clears the fat from most blood remnants and is able to possibly maintain the highest concentration of stem cells within the processed lipoaspirates” (3). For fat processing, centrifugation at a low speed is preferable to high-speed centrifugation, sedimentation by gravity or filtering technique. Research determined that fat grafts processed with centrifugation at 1200 g for 3 minutes have better viability and should be recommend for processing fat grafts.

Third, high success rates of fat survival can be achieved by choosing a proper method of placement. After the harvested fat is purified, the surgeon carefully transfers fat cells into each buttock. To do so successfully, he or she will make small incisions (less than 1cm in diameter) in the butt cheeks and use a hollow tube to insert small quantities of fat cells into each side of the buttocks (micro-fat injections). This process is repeated until the desired correction has been achieved, creating a grid of grafted fat. At the end, the surgeon proceeds to massage the grafted areas to create a satisfactory contour. By all means, fat placement requires slow injection techniques and is time consuming. Clinical studies in patients found that “a slow injection speed of 0.5 to 1.0ml/second resulted in larger fat grafts compared with a fast injection speed of 3.0 to 5.0 ml/second” (4). Increasing injection speeds can result in cellular damage. The studies also reinforce the principle that fat grafts, once placed, should have a maximal amount of contact with the vascularized tissue in the recipient site for better survival.

Lastly, proper BBL post-operative care and healthy lifestyle habits are factors that significantly affect fat survival. Patients can actively contribute a great deal on the success of the procedure and longevity of the results by following their surgeon’s recovery recommendations. In my experience, patients who successfully avoid sitting or putting pressure on their buttocks or stretching for the first eight weeks after their surgery are much more likely to have long-lasting results than patients who fail to follow this advice. The longevity of transplanted fat cells can also be affected by lifestyle factors. In particular, smoking can lead to the degradation of new cells because reduces circulation throughout the body. By eating right and avoiding cigarettes, patients can considerably increase the longevity of their Brazilian Butt Lift.

References:

(1) Schafer, M.E., et al. “Acute Adipocyte Viability After Third-Generation Ultrasound-Assisted Liposuction”. Aesthetic Surgery Journal. 2013 Jul; 33(5):698-704.

(2) Fisher, C., et al. Comparison of Harvest and Processing Techniques for Fat Grafting and Adipose Stem Cell Isolation. Plastic Reconstructive Surgery. 2013 Aug; 132(2):351-61

(3) Lee L.Q. Pu. “Towards more rationalized approach to autologous fat grafting”. Journal of Plastic, Reconstructive & Aesthetic Surgery.pdfs.semanticscholar.org

(4) Strong, Amy L. “The Current State of Fat Grafting: A Review of Harvesting, Processing, and Injection Techniques”. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov

Potential Complications of a Tummy Tuck Procedure (Abdominoplasty)

One of the most common cosmetic surgeries patients are interested in when they come to my office is the abdominoplasty. This procedure, generally known as tummy tuck, can flatten your abdomen by removing loose, excess fat and skin and tightening muscles in the abdominal wall. One benefit that patients appreciate the most is that it can also remove the stretch marks in your lower abdomen. It is popular following pregnancy, massive weight loss or whenever a saggy abdomen with weak muscles impairs body contour.

            When performed by an experienced board certified plastic surgeon, the abdominoplasty will result in flatter, firmer abdominal contour with narrower waistline that wouldn’t be achieved by liposuction procedures only. All in all, abdominoplasty is a very safe operation. Unfortunately, as with any other cosmetic surgeries, there are post-operative complications that should be addressed by a specialist in a time manner. The most likely possible complications after abdominoplasty are: swelling, infection, wound separation and fluid collections (seromas and hematomas). 

The swelling is manifested in the upper thighs and in some cases in the lower legs. The abdominal skin flap can stay swollen due to lymphatic blockage weeks after surgery. This type of swelling requires compression, because swollen tissues themselves can cause more scarring. To prevent the swelling that can occur following a tummy tuck procedure, I prefer the Lockwood technique because separates less tissues than the standard technique. Moreover, one significant thing you can do to control the swelling after the surgery is to wear the post-op compression garment 24/7 for at least eight weeks. Have in mind that tissues heal better and faster when there is minimal swelling.               

Infection is another possible complication that can occur after abdominoplasty. Usually, I prescribe patients antibiotics during their final pre-operative visit to prevent wound infection. It is important that patients make sure they are not allergic to the antibiotics prescribed by their surgeons. Oral temperature over 100.4 degrees, yellowish or greenish drainage from the incisions and/or foul odor are among the indicators of a possible infection. A suture abscess is typically not dangerous and it’s easily taken care of by lancing the area under a local anesthetic, and packing the small puncture with a medicated gauze. However, infections can also be life threatening, like those of MRSA (Methicillin Resistant Staph Aureus). It’s always best for patients to contact their doctor promptly if they have any sign of infection. Therefore, I facilitate my cell phone number to all of my post-op patients so they can communicate immediately if any problems or concerns arise.  

Wound separation can also be a possible complication after an abdominoplasty. Excess skin tension if too much skin was taking out during the procedure can cause the wound to separate. Small wound separations are easily taken care of by packing the wound with medicated gauze. Slightly larger wound separations can be taken care of by a suction device called a “Vac Dressing”. Large wound separations caused by poor blood supply may need revision and re-approximation of the wound edges in a procedure room.

In any case, I highly recommend patients to schedule an in-person visit to get the wound treated promptly and prevent further complications such as getting the wound infected or extending the recovery period.

Lastly, fluid collections (namely seromas and hematomas) are among the possible complications after a tummy tuck procedure. A seroma is a collection of wound fluid. Sometimes it occurs when patients do not wear the compression garment adequately or he/she has a lot of activity in the post-operative period. For its part, a hematoma is a collection of blood in the dead space. It usually needs to be evacuated because it can be painful, can lead to infection or cause excessive scarring. Although seromas and hematomas can be easily treated with a needle aspiration, the best remedy against fluid collections is prevention. The proper use of compression garments and foam pads (Topifoam pads) over areas of potential fluid accumulation are significantly beneficial to prevent these post-operative complications.   

Large Volume Liposuction: Is it safe?

Numerous studies were published regarding the safety of large volume liposuction.  However, this procedure is safe if performed in the right setting:  performed by a plastic surgeon; anesthesia administered by an anesthesiologist; procedure performed in the hospital; and performed on a patient that is a good surgical candidate,

Before and After Photos of Liposuction performed by Dr. Emmanuel De La Cruz MD.

A retrospective study conducted by Dr. Rohrich revealed "no episodes of pulmonary edema, congestive heart failure exacerbation, or other major complications."

Reference:

Rohrich et al. Fluid resuscitation in liposuction: a retrospective review of 89 consecutive patients. Plastic Reconstrive Surgery. 2006 Feb;117(2):431-5.

VASER Liposuction: A Good Source for Mesenchymal Stromal Cells

Mesenchymal stromal cells (MSCs) are the spindle shaped plastic-adherent cells isolated from bone marrow, adipose, and other tissue sources, with multipotent differentiation capacity in vitro.  These mesenchymal stromal cells could differentiate to bone in vitro and a subset of the cells that has a high proliferative potential . The notion of a mesenchymal stem cell was popularized by Arnold Caplan proposing that MSCs gave rise to bone, cartilage, tendon, ligament, marrow stroma, adipocytes, dermis, muscle and connective tissue. Adipose-derived mesenchymal stromal cells (ASCs) are concentrated in fat tissue, and the ease of harvest via liposuction makes them a particularly interesting cell source.   Thus, fat has been transferred to the face for facial rejuvenation, as well as to the buttock for buttock augmentation.  It has shown that radiation-induced damage skin are dramatically improved by fat transfer.  

Recently, ultrasound-assisted liposuction using VASER liposuction and Lysosonix were found to harvest viable mesenchymal stromal cells.  "UAL samples demonstrated equivalent ASC yield and viability. VASER Liposuction adipose-derived mesenchymal stem cells showed higher osteogenic and adipogenic marker expression, but a comparable differentiation capacity was observed. Soft tissue healing and neovascularization were significantly enhanced via both UAL-derived ASCs in vivo, and there was no significant difference between the cell therapy groups."

VASER Liposuction allows safe and efficient harvesting of the mesenchymal stromal cellular fraction of adipose tissue and that cells harvested via this approach are suitable for cell therapy and tissue engineering applications.

Recent studies have shown that adipose tissue derived using the VASER liposuction system were viable at harvest and suitable for autologous fat grafts, such as in Brazilian Butt Lifts.   The study had shown that "the lipolysis assay revealed metabolically active adipocytes with a mean (SD) correlative viability of 85.1%. Direct measures of acute viability via propidium iodide staining resulted in a mean (SD) viability measure of 88.7%.

Reference:

Duscher, et al. Ultrasound-assisted liposuction provides a source for functional adipose-derived stromal cells. Cytotherapy. 2017 Sep 13. pii: S1465-3249(17)30658-8. doi: 10.1016/j.jcyt.2017.07.013. [Epub ahead of print]

Schafer et al.  Acute adipocyte viability after third-generation ultrasound-assisted liposuction.  Aesthetic Surgery Journal. 2013 Jul;33(5):698-704. doi: 10.1177/1090820X13485239. Epub 2013 May 29.

Emmanuel De La Cruz MD, PLLC

Houston Plastic Surgeon

SmartLipo versus Traditional Tumescent Liposuction - Houston, Texas

A previous randomized clinical trial comparing traditional tumescent liposuction and SmartLipo was performed, and this showed the following findings:

• Less post-operative pain with SmartLipo.
• Cytologic studies showed more damage of the adipocytes (fat cells) in SmartLipo.  Thus, fat harvested from SmartLipo is not suitable for fat grafting, such as in Brazilian Butt Lift.
• No major clinical differences found between SmartLipo versus Traditional Tumescent liposuction.
• Surgical time was longer with the SmartLipo group.
• Higher concentration of free fatty acids were found in the SmartLipo group.
• Lipocrit is lower in the SmartLipo group.

Lower Lipocrit Volume was obtained with the SmartLipo group as compared to the Traditional Tumescent Liposuction group.

In conclusion:  "No major clinical differences for suction-assisted lipoplasty versus laser-assisted lipoplasty were found. Higher concentrations of free-fatty acids after laser-assisted lipoplasty must alert us to possible hepatic and renal toxicity."

Reference:  Prado, et al. A prospective, randomized, double-blind, controlled clinical trial comparing laser-assisted lipoplasty with suction-assisted lipoplasty. Plast Reconstr Surg. 2006 Sep 15;118(4):1032-45.

Emmanuel De La Cruz MD, PLLC

Plastic & Reconstructive Surgeon

Houston, Texas

Skin Retraction After VASER Liposuction

A recent randomized clinical trial had shown that the VASER liposuction produced clinical significant skin retraction. 

• "Regarding skin retraction, the VASER-assisted lipoplasty-treated side resulted in a statistically significant improvement in skin retraction of 53 percent relative to suction-assisted lipoplasty (17 percent per liter versus 11 percent per liter, p = 0.003) with 33 paired sites using a two-tailed t test. "

Figure 1:  Before and After Photos (3 months after surgery) after VASER Hi-Definition Liposuction performed by Dr. De La Cruz.  Note that there was significant skin retraction after surgery.

Reference:

Nagy, et al.. A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted Lipoplasty and suction-assisted Lipoplasty. Plast Reconstr Surg. 2012 Apr;129(4):681e-9e. doi: 10.1097/PRS.0b013e3182442274.

Emmanuel De La Cruz MD, PLLC

Plastic & Reconstructive Surgeon

Improvement of Diabetes after a VASER Liposuction

Recently, there has been a study conducted to examine the liposuction-induced metabolic changes with regard to release of major adipokines and insulin sensitivity in overweight male patients.

Figure 1:  Before and After Photos (6 weeks after surgery) of 4 D VASER Liposuction performed by Dr. Emmanuel De La Cruz in Houston, Texas.

• "To eliminate the confounding effects of postsurgical inflammation and to evaluate delayed metabolic effects, fasting blood was collected on the day of liposuction, within 1 to 2 months and more than 6 months after surgery."
• "Both treatment groups (diabetic and nondiabetic patients) experienced similar postsurgical weight reduction with concomitant lowering of body mass index value at 1 to 2 months follow-up, which was sustained after 6 months from surgery."
• "Improvement in insulin sensitivity at 1 to 2 months follow-up was observed ( p = .017 and p = .002, for diabetics and nondiabetics, respectively) and this change persisted over the next 4 months."

This study shows that there may be beneficial effects of VASER Liposuction in overweight diabetic and non-diabetic males by improving their insulin sensitivity.

Reference:

Gibas-Dorna, et al.. The Effect of VASER Abdominal Liposuction on Metabolic Profile in Overweight Males.  Am J Mens Health. 2017 Mar;11(2):284-293. doi: 10.1177/1557988316674841. Epub 2016 Oct 22.

Emmanuel De La Cruz MD

Plastic & Reconstructive Surgeon

Abdominal Exercises to Maintain your 6-Pack after 4D VASER Liposuction

After your surgery, it is critical to maintain your new body with exercise and diet. Your results are optimized if you live a healthy lifestyle which includes exercise at least 3 days a week, and a healthy diet with minimal caloric intake.

Here's a video I recommend to maintain your 6-pack after the 4 D VASER liposuction.  Your results will be optimized when you do this exercise.

Emmanuel De La Cruz MD, PLLC

Plastic & Reconstructive Surgeon

Fat Graft Harvested via VASER Liposuction is Viable and Suitable for Fat Transfer in Brazilian Butt Lift Patients

Although there's clinical evidence of successful autologous fat transfer (AFT), such as in Brazilian Butt Lift, using VASER liposuction is readily available, no study has quantified adipocyte viability using standardized methods until recently.

• The UAL system (VASER; Sound Surgical Technologies, Inc, Louisville, Colorado) was set at 60% amplitude in pulsed mode with vacuum aspiration of 15 in Hg or less.
• Laboratory analysis included free lipid volume, viability via lipolysis and propidium iodide staining, and cytological analysis, including cell surface protein examination and hematoxylin and eosin staining.
• The lipolysis assay revealed metabolically active adipocytes with a mean (SD) correlative viability of 85.1%
• Direct measures of acute viability via propidium iodide staining resulted in a mean (SD) viability measure of 88.7%
• Adipose tissue acquired via VASER liposuction is viable at harvest and isa suitable source for autologous fat grafts, especially for Brazilian Butt Lift.
• Adiposed-derived stem cells (fat for fat transfer) obtained via VASER liposuction were of equal quality when directly compared with the current gold standard harvest method according to a study conducted by Duscher.   "UAL- and SAL-derived samples demonstrated equivalent ASC yield and viability, and UAL ASCs were not impaired in their osteogenic, adipogenic, or chondrogenic differentiation capacity."

4D VASER Liposuction performed by Dr. Emmanuel De La Cruz of Houston, Texas

Reference:

Duscher, et al. Ultrasound-Assisted Liposuction Does Not Compromise the Regenerative Potential of Adipose-Derived Stem Cells.  Stem Cells Transl Med. 2016 Feb;5(2):248-57. doi: 10.5966/sctm.2015-0064. Epub 2015 Dec 23.

Schafer, et al.  Acute adipocyte viability after third-generation ultrasound-assisted liposuction. Aesthet Surg J. 2013 Jul;33(5):698-704. doi: 10.1177/1090820X13485239. Epub 2013 May 29.

VASER Liposuction on Gynecomastia for Men

Gynecomastia describes a benign increase of the mammary gland in men.   This could range from a puffiness or localized button of tissue concentrated around the areola to marked, distinct enlargement of the breasts making the breasts looking feminine.  Gynecomastia or the so-called "man-boob" can be secondary to multiple causes such as marijuana usage; certain medications such as Pepcid/Tagamet/cardiac medications; testicular tumors; thyroid abnormalities; pre-pubertal enlargement, etc.  Most cases of gynaecomastia are benign and of cosmetic, rather than clinical, importance.  However, gynecomastia may cause local pain and tenderness, and this could occasionally be the result of a serious underlying illness or a medication, or be inherited.   Most cases of gynecomastia result from deficient androgen action or excessive estrogen action in the breast tissue.  In  pubertal gynecomastia, the breast enlargement may resolve spontaneously and thus may warrant observation for gynecomastia in children.

Before & After Photos of VASER Liposuction of the Breasts for treatment of Gynecomastia.  Note that the patient also underwent the 4D VASER Hi-Definition Liposuction.  Procedure performed by Dr. De La Cruz

When medical treatment fails, the surgical procedure is the treatment of choice.  Numerous surgical techniques exist for gynecomastia treatment.  This could range from using the VASER liposuction or ultrasonic liposuction to direct excision of gynecomastia.  Recent studies have shown that ultrasonic liposuction for the treatment of mild to moderate gynecomastia showed superior results over conventional liposuction methods.

A total of 219 patients (384 breasts) with a mean age of 29 years (range 12-74) were evaluated. UAL was utilised in 24% of breasts (47 patients, 91 breasts). Compared with conventional liposuction, UAL had significantly lower rates of intraoperative conversion to open excision (25% vs. 39%; p<0.05) and postoperative revision (2% vs. 19%; p<0.001) using Fisher's exact test. The haematoma rate for each technique was 1%.

Recently, subcutaneous mastectomy was compared with ultrasonic-liposuction for the treatment of gynecomastia.  The reoperation rates in the mastectomy group and liposuction group were 1.4% and 0.5%, respectively. There were no nipple/areola necrosis and scars in liposuction group.  The ultrasonic-liposuction treatment was associated with superior esthetic results and fewer complications.

The use of ultrasonic-assisted liposuction (UAL) combined with conventional liposuction and partial gland resection without skin excision is an option for moderate cases.  Although a wide range of surgical techniques have been described, the treatment of gynecomastia requires an individualized approach. 

Reference:

Song et al.  Surgical treatment of gynecomastia:  mastectomy compared to liposuction techniques.  Ann Plast Surg. 2014 Sep;73(3):275-8. doi: 10.1097/SAP.0b013e31827c7949.

Wong, et al.. Conventional versus ultrasound-assisted liposuction in gynecomastia surgery:  a 13-year review. J Plast Reconstr Aesthet Surg. 2014 Jul;67(7):921-6. doi: 10.1016/j.bjps.2014.03.004. Epub 2014 Mar 21. 

Emmanuel De La Cruz MD, PLLC

Plastic & Reconstructive Surgeon

Houston, Texas

Treatment of Excessive Sweating or Hyperhydrosis with VASER Liposuction

Current methods to treat excessive sweating of the arm pits or axillary hyperhidrosis are typically palliative.   This may involve the use of topical aluminum chloride or cosmetic injections.  For a more permanent solution of excessive sweating of the arm pits may include excisional surgery, endoscopic transthoracic sympathectomy, and liposuction/curettage.

VASER Liposuction as Treatment for Axillary Hyperhydrosis

• A  prospective study was performed involving 13 patients with hyperhydrosis.  The patients were treated with the VASER liposuction.  11 of 13 patients had "significant reduction in sweat/odor and had no recurrence of significant symptoms at 6 months".
• It is unknown, however, whether the use of the VASER liposuction is permanent or not.
• Axillary liposuction using the VASER liposuction machine promises to be the surgical treatment of choice for those patients refractory to other modalities. 

Emmanuel De La Cruz MD, PLLC

References:

Commons, et al.  Treatment of axillary hyperhidrosis/bromidrosis using VASER ultrasound.Aesthetic Plast Surg. 2009 May;33(3):312-23. doi: 10.1007/s00266-008-9283-y. Epub 2009 Jan 3.

Brazilian Butt Lift | Fat Transfer to Buttock in Houston, Texas

From an evolutionary standpoint, an hourglass figure with a narrow waist and full buttocks is associated with female reproductive potential and has been considered an aesthetic ideal across cultures.  A round, well-projected buttock indicates fertility and youth in a woman and is considered aesthetically pleasing.  With the popularity of several celebrities' derriere such as those of Kim Kardashian, Jennifer Lopez, Beyonce and Sofia Vergara, the plastic surgery procedure called Brazilian Butt Lift has become more popular among women.

What is the Brazilian Butt Lift?

• This plastic surgery procedure involves liposuction and the transfer of fat into the buttock.
• The 4 D VASER Hi-Definition liposcuplture incorporates the transfer of fat into the buttock as part of the procedure.  Not only one will have an athletic figure, the buttock is also enhanced to produce a more aesthetically pleasing body.
• The fat is harvested using the Coleman technique, and the fat is then transferred into the buttock to produce a more rounded and more voluptuous buttock.

Figure1:  Before & After Photos of 4 D VASER Hi-Definition Liposuction with Brazilian Butt Lift (6 DAYS after Surgery.)  Procedure performed by Dr. Emmanuel De La Cruz in Houston, TX.

Figure 2:  Before & After photos of Brazilian Butt Lift  (24 HOURS after Surgery.)  Procedure performed by Dr. Emmanuel De La Cruz in Houston, TX.

Emmanuel De La Cruz MD, PLLC

Plastic & Reconstructive Surgeon

Houston, TX | The Woodlands, TX

4D VASER High-Definition Liposuction

Abdominal etching was initially developed by Dr. Mentz in 1993.  It was a liposuction technique defining the rectus abdominis muscle to create the 6-pack in men.   With this technique, the linea alba in the middle of the rectus abdominis muscle is etched with the outline of the muscles.   Horizontal lines are then created to sculpt a 6-pack.

Figure 1: 4-D VASER High Definition Liposculpture by Dr. Alfredo Hoyos from Colombia. www.alfredohoyos.com

4D VASER Liposculpture performed by Colombian Plastic Surgeon Dr. Alfredo Hoyos.  Note that the procedure involves sculpting the chest, abdomen, flanks, back and arms.

This technique was further enhanced and improved by a Colombian plastic surgeon Dr. Alfredo Hoyos using the VASER liposuction technology.  VASER (acronym for Vibration Amplification of Sound Energy at Resonance) is an ultrasound-assisted liposuction that utilizes ultrasound energy to selectively remove fat without harming the surrounding structures of the area being liposuctioned.

Figure 1: Before & After Photos of 4D VASER High Definition Liposculpture (6 weeks after surgery) performed by Houston Plastic Surgeon Dr. Emmanuel De La Cruz MD, PLLC. Note that final definition is typically seen 3-4 months after surgery. Patient went from a size 6 to a size 2. Result may vary individually.

 

Figure 3:  Dr. Alfredo Hoyos, the pioneer of the 4D VASER Liposculpture and other plastic surgeons from all over the world (Slovenia, USA [Dr. De La Cruz], Colombia, Egypt and Spain) who perform the 4D VASER High Definition Liposuction.

How Does the VASER Liposuction Work?

VASER liposuction is a minimally invasive liposuction procedure performed in conjunction with tumescent anesthesia that utilizes advanced ultrasound technology designed to gently reshape the body. The ultrasound energy is transmitted through the small VASER probes that diffuse the ultrasound waves and liquefy the fat for easy removal. The ultrasound energy is gentle enough that it can break apart the fat with minimal damage to surrounding tissues, creating smooth, predictable results with fast patient recovery.

Clinical Study

A multicenter, prospective randomized controlled trial in 2012 recently showed that the VASER-assisted liposuction resulted in a statistically significant improvement in skin retraction of 53 percent relative to the traditional regular liposuction (17 percent per liter versus 11 percent per liter, p = 0.003). Moreover, the VASER-assisted liposuction group also resulted in a statistically significant reduction in blood loss of 26 percent relative to the traditional liposuction (p = 0.019 with n = 20 using a two-tailed t test).

FAST FACTS about VASER LIPOSUCTION

• The VASER-liposuction method demonstrated improved skin retraction compared with traditional/conventional liposuction.
• The VASER-liposuction method demonstrated reduction in blood loss compared with traditional liposuction.
• No serious complications reported in a clinical study involving VASER liposuction in over 70,000 VASER liposuction procedures.
• No burn complications, contour irregularities or prolonged swelling seen in one clinical study.
• No revisions needed after a VASER liposuction found in a multi-center pilot study.

KEY BENEFITS of VASERlipo:

• Single procedure results with speedy recovery times
• Less bleeding & more skin retraction
• Improved body contouring over traditional liposuction
• Refines and accentuates appearance of muscles
• It's the RECOMMENDED type of liposuction for treatment of gynecomastia in men

Recovery after a 4-D VASER High Definition Liposuction

• May return to work 3-5 days after surgery
• May resume exercise or work out 1-2 weeks after surgery

Emmanuel De La Cruz M.D. PLLC

Houston Plastic & Reconstructive Surgeon | Cosmetic Surgeon

Certified 4D VASER High Definition Liposculpture Surgeon

Call NOW at 832-520-1844

Clinic Locations: The Galleria in Houston, TX & The Woodlands, TX

SMART Liposuction vs Traditional Liposuction

Comparison of SmartLipo versus Traditional Liposuction

• A prospective randomized clinical study showed that there's no clinical difference between the traditional liposuction versus laser-assisted liposuction using the SmartLipo machine.

•  There's less pain, lower lipocrits, higher triglycerides, and DNA cellular membrane traces were detected in the laser-assisted lipoplasty sides as compared to the traditional liposuction.

• Higher concentrations of free-fatty acids after laser-assisted lipoplasty was found.  It's recommended that this should alert us to any possible hepatic and renal toxicity.

References:

Pradeo, et al. A prospective, randomized, double-blind, controlled clinical trial comparing laser-assisted lipoplasty with suction-assisted lipoplasty. Plast Reconstr Surg. 2006 Sep 15;118(4):1032-45.