The Cut Above the Suck: My Stand on Liposuction vs. Excisional Procedures

In our never-ending pursuit of aesthetic perfection, the comparison between liposuction and excisional procedures is a debate that resonates deeply within the culture of beauty and body image. At the heart of this debate is the question of invasiveness and efficacy—when presented with these two surgical approaches, which is truly the cut above the other?

Liposuction represents a beacon of hope for individuals sculpting their ideal form. It is a vacuum-powered solution that promises to rid the body of stubborn fat deposits in a few weeks with minimal pain.

In contrast, excisional procedures, notably exemplified by the traditional tummy tuck, offer a more direct, albeit more invasive, answer to shaping the physique.

Both methods have their pros and cons, but which should be considered the superior choice? As a board-certified plastic surgeon by the American Board of Plastic Surgery, Dr. Amir Ghaznavi has the experience and expertise to give you an idea.

What is Liposuction?

Liposuction, as its name suggests, involves suctioning out fat cells from targeted body areas. This surgical procedure is most suitable for individuals with localized body fat accumulation in specific areas such as the abdomen, hips or thighs. It is a relatively quick procedure that typically requires only local anesthesia and promises minimal scarring, making it a popular choice for those seeking a more subtle change in their body shape and removal of excess fat.

The amount of fat removed is determined during your consultation and can vary depending on the patient’s goals and medical condition. Some patients may need multiple liposuction sessions to achieve their desired results, while others may see significant changes with just one procedure.

How is Liposuction done?

The liposuction procedure takes 30 minutes to a few hours, depending on the treatment area’s size. Small incisions are made in the targeted areas when done in an operating room while on an exam table. Then, a numbing saline solution is injected under the incisions to help emulsify the fat and numb the treatment areas that feel pain. Then, a thin tube called a cannula is inserted to suction out the stubborn pockets of excess fat. Dr. Ghaznavi will then move the cannula back and forth to break up the fat cells before removing them through the vacuum. This form of contouring helps with muscle definition and achieves a more toned and sculpted look.

Abdominal liposuction can be performed using tumescent, ultrasound-assisted, or laser-assisted liposuction techniques. Each technique has benefits and may be more suitable for particular individuals based on their body type and desired results. Other procedures can also be done in conjunction to improve aesthetic results.

If done under local anesthesia, patients can get up and walk immediately after the procedure, while general anesthesia may require a few hours of recovery before being able to leave.

What happens after Liposuction?

Patients are advised to wear compression garments during the post-operative period after liposuction to help reduce swelling and promote proper healing. Most patients can return to their normal activities within a week, although strenuous activity should be avoided for a few weeks.

Pros of Liposuction

• Minimal scarring
• Quick procedure with a short recovery time
• Can target specific areas of the body
• Less invasive compared to excisional procedures
• Can be done under local anesthesia

Cons of Liposuction

• Not a weight loss solution
• Can cause irregularities in the skin’s surface
• May require multiple sessions for desired results
• Fat can return if unhealthy lifestyle habits continue

The Misconceptions of Liposuction

The allure of liposuction lies in its portrayal as a quick fix—a simple, outpatient procedure that sucks the fat cells away, leaving the patient with a svelte silhouette and a flat stomach. However, such a nonchalant depiction glosses over the risks associated with this type of surgery.

While liposuction is generally safe when performed by a board-certified plastic surgeon, the potential risks and the possible complications should not be overlooked. These can include infection, bleeding, and adverse reactions to anesthesia.

There is also the possibility of contour irregularities, where the skin may appear bumpy or withered due to uneven fat removal or poor skin elasticity.

Additionally, though usually temporary pain, nerve damage or numbness in the treated area can occur.

Additionally, though rare, there is a risk that during the abdominal liposuction procedure, the surgical instruments may inadvertently penetrate too deeply, potentially leading to perforation of internal organs. This serious complication can require immediate medical attention and possibly further surgical procedures to repair the damage, highlighting the importance of selecting a highly experienced surgeon like Dr. Amir Ghaznavi.

Don’t turn into a prune: your skin elasticity is key.

The concept of skin elasticity in liposuction is very important. Think of this like a balloon. As you blow it up, the skin stretches and gets tight. Well, it is the same with abdominal liposuction when we remove fat from under the skin.

If there is not good elasticity, then as we suck out the fat, the skin may not snap back to its smooth state, leaving behind a less-than-desirable appearance. This is especially important for older patients, as skin elasticity naturally decreases with age.

Can the skin be Tightened?

To optimize liposuction results and address concerns regarding skin elasticity post-liposuction, combining the procedure with innovative skin tightening treatments, such as Renuvion, or “J-plasma”, can be highly beneficial.

Renuvion, known for its cutting-edge technology, utilizes a combination of helium plasma and radiofrequency energy through a thin tube to precisely target and tighten the skin from within.

This complementary procedure can significantly enhance the smoothness and contour of the skin, making it an ideal option for those looking to tighten the skin further after liposuction.

Fat on the inside (Viscveral) vs Fat on the outside (Subcutaneous)

Understanding the distinction between visceral and subcutaneous fat is crucial in setting realistic expectations for stomach liposuction outcomes.

Subcutaneous fat, located just beneath the skin and above the muscle, is the primary target for abdominal liposuction. This type of fat is more accessible and can be effectively removed through the procedure, leading to the aesthetically pleasing results patients often seek. The amount of fat removed with stomach liposuction depends on the volume of pinchable fat under the skin.

On the other hand, visceral fat tissue, which resides deeper within the abdominal cavity surrounding the organs, cannot be removed via abdominal liposuction. Visceral fat is more closely linked with health concerns such as cardiovascular diseases and diabetes, and its reduction is best achieved through healthy diet, exercise, and lifestyle changes rather than abdominal liposuction.

Understanding this distinction is essential for patients to have realistic expectations about what stomach liposuction can and cannot offer regarding body shaping and a flat stomach.

Long-term Fat Removal ?

It is important to maintain a healthy lifestyle and diet to maintain results from liposuction. While stomach liposuction can remove stubborn fat pockets, it cannot prevent future weight gain or eliminate visceral fat. If you gain weight after liposuction, your fat levels may change. For example, you may gain fat around your abdomen no matter what areas were originally treated. Thus, patients should continue to prioritize healthy habits to achieve long-term results.

Maintaining a stable weight and engaging in regular exercise helps preserve the results of liposuction and improves overall health and well-being. Additionally, incorporating a balanced diet with proper nutrition is crucial for maintaining a flat stomach after stomach liposuction.

What is Excisional Procedures?

Excisional procedures, also known as surgical body contouring, involve physically removing excess skin and tissue from the body. This method is typically used for individuals with more significant amounts of loose skin and fat, often resulting from weight loss or pregnancy. Unlike liposuction, this procedure requires general anesthesia and involves longer recovery times due to its invasiveness.

The most common excisional procedures are abdominoplasty (also known as a tummy tuck), brachioplasty (arm lift), thighplasty (thigh lift), and lower body lifts. Each procedure involves making incisions along the targeted area and removing excess skin and tissue before closing the incisions with sutures.

In some cases, liposuction may also be combined with excisional procedures to enhance results and contour the body further.

While this method can provide an invasive procedure with more dramatic changes to a person’s body shape, it carries higher risks of complications and scarring compared to liposuction.

The Advantages and Disadvantages of Excisional Procedures

Pros of Excisional Procedures

• Addresses skin laxity and muscle separation
• Can lead to significant weight loss in the form of excess tissue removal
• Long-lasting results
• Can improve the quality of life and self-esteem of individuals with excess skin

Cons of Excisional Procedures

• Requires general anesthesia, which carries risks and longer recovery times
• Leaves more noticeable scarring compared to liposuction
• Higher risk of complications such as infection or blood clots
• Limited to specific areas and may require multiple surgeries for full-body

The Truth About Tucks

Excisional surgeries cut to the chase—quite literally. For example, a tummy tuck, or abdominoplasty, involves the removal of excess skin and fat from the middle and lower abdomen to tighten the muscle fascia.

This procedure confronts the visible aftermath of weight fluctuations and aging head-on, yielding results that are not just shallow but deep and holistic. However, with the promise of a more sculpted silhouette comes significant downsides.

The Dark Side

As mentioned earlier, excisional procedures carry higher risks compared to liposuction. In addition to general anesthesia and recovery time concerns, these surgeries also have potential complications that can significantly impact the healing process and final results. Some possible side effects and risks include:

• Wound separation or opening of the incision site
• Seroma, a buildup of fluid under the skin
• Hematoma, a collection of blood outside of a blood vessel
• Nerve damage leading to numbness or loss of sensation in the treated area
• Delayed wound healing due to poor blood flow or infection

The Unavoidable Scars

Another major downside of excisional procedures is the scarring that comes with them. While all surgeries leave scars, excisional procedures often result in more noticeable and extensive scarring due to the removal of excess skin. This can be a significant concern for individuals who have undergone this type of surgery to improve their appearance, as it may affect their self-esteem.

However, like all scars, they do fade over time. Plastic surgeons are trained to place them in inconspicuous areas, and we are trained in techniques to avoid excessive scarring.

It is essential to discuss and understand the potential scarring with Dr. Ghaznavi before proceeding with any excisional procedure.

Loose skin determines all

The deciding factor between opting for a less invasive treatment like liposuction and choosing an excisional procedure often boils down to the extent of loose skin present.

While liposuction efficiently removes fat tissue, it does not address significant skin laxity, which can result in a less than satisfactory outcome for individuals with significant skin excess.

Excisional surgery, therefore, become indispensable for those seeking fat reduction and a firmer, more contoured appearance. This approach is particularly beneficial for patients who have experienced major weight loss or the natural skin relaxation associated with aging, where skin elasticity is compromised, and the only viable solution is surgical removal of the redundant skin.

Beyond Skin Deep

The crux of the debate on liposuction versus excisional procedures is multifaceted. It is imperative to consider that the choice between these treatments is not one of a procedure’s popularity but rather of what it can truly offer in the long term.

For individuals seeking a profound transformation, a tuck can provide structural change accompanying them to pursue a healthier lifestyle.

The common narratives surrounding liposuction—of trivialized risks and instantaneous rewards—underscore a societal preference for the path of least resistance. It is time to reevaluate our perceptions of what constitutes a worthwhile endeavor in our quest for physical perfection.

Both in content and delivery, excisional procedures presently appear to provide a more comprehensive, albeit more demanding, form of self-improvement.

The Bottom Line

In the end, the choice between a liposuction procedure and an excisional procedure is deeply personal and should be made with the guidance of a qualified medical professional. It reflects our values and priorities in terms of our appearance and our approach to solving problems—skin deep or beyond.

The efficacy of any cosmetic surgery is measured not only by the transformation it can afford but also by the support and understanding one receives throughout the process. Each individual’s body is a unique canvas. When considering the canvas of one’s own, it is the deeper, more encompassing potential of an excisional procedure that just might make you stand to reason. Sometimes, a cut truly is a step above the suck.

Words of advice…

Remember, transformation is a process that takes time and effort but ultimately leads to lasting change. I remind patients that it took many years for the excess fat or loose skin to appear, and it will be a journey to remove and contour it.

However, with proper care and follow-up, the results of either procedure can be maintained for years to come, even if you gain weight. It’s important to listen to your body and give it proper rest and nourishment during healing. And most importantly, always prioritize your health over any aesthetic goals.

Whatever decision you make, whether it’s stomach liposuction or tummy tuck, Dr. Amir Ghaznavi at AMG Plastic Surgery is here to help you feel good about being you.