Modern Liposuction

Liposuction technqiues have seen some signifcant advances in recent years, the most important ones being minimally invasive techniques such as water jetstream assisted liposuction (Body Jet or Aqua Lipo, as it is often called in the U.S.) and the laser liposuction technique.

In many cases, the best way forward is to combine the two.

The main advantage of jet stream assisted liposuction is as follows: no extensive infiltration of fluids is required and therefore it is much more precise, it is virtually bloodless and enables removal of large quantities of fat in a relatively short time.

The third, and crucial advantage of the water jetstream assisted liposuction technique is that it enables to simultaneously harvest excellent quality fat grafts, which in our practice is mainly used for breast and buttock augmentation as well as a natural filler in facial rejuvenation.

Body Jet uses a very precise waterstream to remove fat preserving viability of the cells. The fat harvested in this way can be used to inject it elsewhere.
The basis for Body Jet is that the fat harvested in this way contains all its inherent growth factors and stem cells, resulting in optimum conditions for graft survival.

The main advantage of laser liposuction is that it provides very even and reliable retraction of the skin. I like to use the laser technique especially for arms and neck (double chin deformity).

In cases of larger deposits, it is ideal to first remove the deeper bulk of fat with Body Jet liposuction, and then treat the more superficial layer with the laser for best skin retraction.

Both of the abovementioned body contouring techniques have significant advantages over “conventional” liposuction.

I have in fact completely abandoned tumescent lipsouctuion in my department.
Tumescent liposuction, to my opinion is an outdated technqiue which has no other advantage than it does not reuqire any major investments in gear other than a suction tube and a cannula.

Both techniques, laser liposuction and water jet stream assisted liposuction are day case procedures under local anesthetic.

For more information visit our Homepage:
www.beautymedicine.es/liposuction-smartlipo

Gynecomastia…….scar free male breast reduction

Whilst it is difficult to verify exact statistics, it seems that gynecomastia (male breast reduction) is the most frequent request for cosmetic surgery among males, competing with liposuction and rhinoplasty.

There is a multitude of reasons for the condition, we have clearly identified a few drugs causing it, I personally see increasing numbers of steroid abusers.

Other common culprits causing gynecomastia are a couple of antihypertensive drugs, hormonal problems, and often, simply genetic predisposition to gynecomastia (in other words bad luck).

What is the ideal age for operating a gynecomastia?

There is none because the problem can occur at very different ages. Depending on the cause, the ideal age is when the condition becomes unbearable for patients. The most difficult question is normally what to do with young patient. Whilst cosmetic operations on miors are obsolete, gynecomastia is not strictly cosmetic and psychological distress can be unbearable.

Under these circumstances psychological distress for patients may well be unbearable and needs relief.

Does social insurance pay for gynecomastia ?

That depends. Some insurers, at least in Spain, accept grade II+ grades as medical indications. This reflects my opinion as well, certain degress of gynecomastia are rather resonstructive by nature than cosmetic. Not all insurers share my opinion though.

In Spain the majority of cases are treated outside the social insucrance system,

Can gynecomastia be solved by liposuction alone?

In selected cases yes.

In most cases resection of breast gland will be necessary.However, this depends always of the individual case.

As a rule of thumb, being deliberately vague, one can say that the older you are the more fatty tissue you will find and the more likely liposuction alone will be successful. However, we do not use “classical” liposuction” anyway. Both myself and all other surgeons of my team seem to find this a rather traumatic and outdated technique.

In gynecomastia, we prefer the endolaser technique (has become very popular as “Smartlio”) in the US. We have found that increasing the energy level of the laser to a higher level and changing into “cutting” mode enables us to destroy the glandular tissue with laser alone and no incision are necessary.

What scars are involved ?

None. The endolaser technique, which is the technique that we prefer, does not leave any scars. The endolaser does lead to significant skin retraction, so there are no problems with lax skin.

92% of our gynecomastia cases are now done with the scar-free endolaser technique.

What is the biggest problem around gynecomastia ?

Recurrence. The gland behind the nipple needs to be resected in true gynecomastia cases, some part of it will usually remain and possibly lead to recurrence. There is no difference regarding recurrence whether classical surgical incision or endolaser is used, and the percentage is about 2-3% (higher in steroid abusers).

What is recovery time after a gynecomastia operation ?

Usually very short, defintely depending on the extent of resection. The scar free endolaser technique for male breast reduction is an ambulatory day case procedure, and there is no physical recoevry.

I like to use a compression garment of a minimum of two weeks post surgery, possibly longer.

For more information visit our Homepage:
www.beautymedicine.es/gynecomastia