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Liposuction (suction-assisted lipectomy) is a surgical procedure performed to remove unwanted deposits of fat from specific areas of the body. Liposuction is not a surgical treatment for being overweight. Overweight individuals who intend to lose weight should postpone surgery until they are able to maintain a stable weight.

The best candidates for liposuction are individuals of relatively normal weight who have localized areas of excess fat that have not responded to dieting and exercise. Having firm, elastic skin will generally result in a better contour following liposuction. Liposuction will not improve skin tone and will not improve areas of dimpled skin (cellulite).

Areas commonly treated by liposuction include the abdomen, "love handles", hips, upper torso (adjacent to the breasts), back, inner and outer thighs, inner knees, chest (in men), arms, and chin.

Dr. Friedman generally performs superwet liposuction to minimize bleeding and bruising after surgery. This involves the infiltration of a dilute fluid containing lidocaine (a local anesthetic) and epinephrine (adrenaline) into areas of excess fat. A hollow metal tube (cannula) is then inserted through quarter-inch skin incisions and passed back and forth through the fatty deposits. The cannula is attached to a vacuum source to remove the fat. Depending on the areas treated, fat removal may vary from several ounces to several pounds. As an experienced liposuction surgeon, Dr. Friedman has performed well over a thousand liposuction procedures.

Dr. Friedman performs most liposuction procedures under general anesthesia on an outpatient basis. The procedure is performed in his AAAASF-accredited surgical facility, the West Plano Plastic Surgery Center, which is located on the campus of Texas Health Presbyterian Hospital of Plano. He strictly uses physicians—not nurses or technicians—to administer your anesthesia.

Pain medication is necessary for about a week following surgery. Most patients return to light activities within 3 to 5 days, depending on the areas treated. Strenuous exercise should be avoided for approximately one month following liposuction, in order to minimize the risk of excessive swelling or bleeding (hematoma). A compression garment must be worn over the liposuction sites continuously for one month and intermittently for a second month to maximize the surgical result.

What about the fat under my chin?

Dr. Friedman usually performs liposuction under the chin (submental liposuction) using local anesthesia (tumescent liposuction) with nitrous oxide (laughing gas), rather than general anesthesia. Only one quarter-inch incision is required, and this is well-concealed. The procedure usually takes about 45 minutes. If desired, you can drive yourself home afterwards.

Liposuction can be performed for spot reduction of problem areas, as full body liposuction, or in conjunction with other surgical procedures, such as:

Tummy tuck: Unlike many plastic surgeons, Dr. Friedman routinely performs liposuction of the abdomen as part of most tummy tucks. This enables better shape and greater flattening of the abdomen. Many tummy tuck patients also request narrowing of the waistline by liposuction.

Breast reduction / breast lift: Liposuction of the outer torso adjacent to the breasts can reduce the wrap-around look of the breasts, providing a more definite outer breast border.

Male breast reduction: In most men with gynecomastia (enlarged male breasts), liposuction of the breasts is performed in conjunction with surgical removal of fibrous tissues. Liposuction in men is also commonly performed for the abdomen and love handles.

Mommy makeover: Liposuction of the torso is almost always part of the combined breast and abdominal surgery known as “mommy makeover.”

Armlift / thighlift: Liposuction of the extremities is frequently performed in conjunction with armlift, thighlift, and other body contouring procedures following major weight loss.

When you visit our office, Dr. Friedman will discuss your specific concerns. He will give you a realistic idea of what you can expect from surgery. We will also show you a variety of "before and after" photos of liposuction procedures performed by Dr. Friedman. If you wish to speak to other patients who have undergone these procedures, we will be happy to provide phone numbers.

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Dr. Friedman explains liposuction.

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Q & A: Liposuction

Will the fat come back?

The fat cells that are removed by liposuction cannot regenerate. They are gone forever. However, if you gain 20 or 30 pounds, all bets are off. The remaining fat cells will become larger, and you will regain fat. The areas that were previously suctioned will be more resistant to weight gain than areas that were never treated. But all areas will enlarge to some degree if you gain weight after surgery.

If you maintain a stable weight after surgery, your results should last for many years.

Which liposuction technique is best?

Superwet liposuction, tumescent liposuction, ultrasonic liposuction, laser liposuction, vaser liposuction…it gets pretty confusing.

Bottom line: any liposuction technique can yield good or bad results. The training and experience of the surgeon performing your procedure is probably far more important than the technique or machine he or she uses. Evaluate surgeons based on their experience and surgical results.

What is liposculpture?

Liposculpture is nothing more than a marketing term used to describe liposuction. Many physicians advertise that they can sculpt your arms, tummy, and thighs. The reality is that the vast majority of liposuction surgeons have absolutely no background in art or sculpture. In contrast, Dr. Friedman’s interest in plastic surgery stems from his 25 years of experience as an artist and wood and marble sculptor. His artistic eye guides him in the performance of cosmetic surgery, particularly liposuction surgery.

What is mesotherapy?

Mesotherapy involves injection of various substances into the fat in an attempt to “melt” it. Mesotherapy is usually performed by non-plastic surgeons (most often nurses, family doctors, and gynecologists). Unfortunately, there is currently no “hard data” to support the use of mesotherapy. It is Dr. Friedman’s impression that mesotherapy does dissolve fat to some degree but does not do so uniformly. Frequently there are depressions at the injection sites without significant fat reduction in the adjacent tissues. This may give tissues an irregular, quilted appearance.

How much fat can you remove?

Dr. Friedman routinely removes 2 to 4 liters of fat on an outpatient basis. Although there is no fixed limit to fat removal, the American Society of Plastic Surgeons considers anything over 5 liters of fat removal to be “high volume liposuction.” High-volume liposuction must be approached with caution due to increased risk of fluid shifts, blood loss, and blood clots.

Bottom line: if you need more than 5 liters of fat removed, you should consider losing weight before surgery.

What about the fat under my chin?

Dr. Friedman usually performs submental (central neck liposuction under the chin) liposuction using local anesthesia (tumescent liposuction) with nitrous oxide (laughing gas), rather than general anesthesia. Only one quarter-inch incision is required, and this is well-concealed. The procedure usually takes about 45 minutes. If desired, you can drive yourself home afterwards.

How much does liposuction cost?

Liposuction price varies depending upon the number of areas treated. It can be as low as $1750 for liposuction performed under the chin with local anesthesia (see above) or as high as several thousand dollars for full body liposuction.

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Liposuction: Instructions

One week before surgery

  1. Do not take aspirin-containing products, as these may increase your risk of bleeding. Use extra-strength Tylenol for any headaches or other minor pains.
  2. Please notify Dr. Friedman's staff if you become sick with a fever, significant cough, etc. If necessary, your surgery can be rescheduled to a time when you are feeling better.
  3. Do not smoke at all or use a nicotine patch for at least two weeks (and preferably 4 weeks) prior to surgery and 4 weeks after surgery. Smoking interferes with wound healing and increases your risk for anesthetic and surgical complications.
  4. Arrange to have a relative or friend drive you home after surgery and stay with you for the evening. You cannot drive yourself home.

The evening before surgery

  1. Do not eat or drink anything for at least 8 hours prior to your scheduled surgery time.
  2. Make some jello and/or soup for after surgery. Have some juice in your refrigerator.
  3. The anesthesiologist will contact you by phone to discuss your medical history and to answer any questions.

Day of surgery: before you leave home

  1. Remember not to eat, drink, or smoke. This includes no chewing gum, mints, etc.
  2. Make sure someone is available to drive you home. Put a pillow and blanket in the car.
  3. Wear loose, comfortable clothing. Avoid heavy make-up, jewelry, or contact lenses. Please do not use any lotion, baby oil, perfume or powder. LEAVE ALL VALUABLES AT HOME!

Day of surgery: at the facility before surgery

  1. Dr. Friedman will talk to you before surgery to answer any last-minute questions. He will mark your areas of undesirable fat to help him accurately plan your surgery.
  2. You will meet the anesthesiologist and surgical nurses.

Day of surgery: at the facility after surgery

  1. You will be taken to the recovery area to wake up after surgery. Dr. Friedman will go to the waiting room to speak to your family/friends.
  2. Approximately 1 hour later, your family can visit you. Once you are feeling well enough, you may go home.

At home after surgery

  1. Have someone stay with you for the first night. You may be weak and drowsy.
  2. Take the antibiotics, pain medication (as needed), and anti-nausea medicine (if needed) that Dr. Friedman has prescribed for you.
  3. Sleep with your head elevated. Sleep on your back (not your stomach or side).
  4. Leave the compression garment on for 3 days. On the third day after surgery, you may temporarily remove the garment and the underlying foam padding and begin showering. Wash your garment and then put the foam and the garment back on. You may shower daily.
  5. It is common to experience temporary drainage from the incision sites, which may be blood-stained. If the drainage is bloody and persistent, contact Dr. Friedman.
  6. Take at least 10 deep breaths every hour. This will help keep your lungs expanded.
  7. Do not be a couch potato. To reduce the risk of blood clots in the legs, get up and walk any time you need to eat or use the bathroom. While you are in bed, repeatedly flex your ankles (moving your toes up and then down) and/or have your family massage your calves.
  8. If you experience a prolonged fever (oral temperature greater than 101), contact Dr. Friedman. Feel free to call our office or to page Dr. Friedman for any other problems or concerns.

Instructions for your first postoperative visit (about one week after surgery)

  1. Activity level

    1 week after surgery: you may resume casual walking but must not engage in vigorous exercise that increases your blood pressure or heart rate. You may resume driving once you are off of your pain medication. Avoid freeways until you are comfortable with city driving.

    4 weeks after surgery: you may gradually resume exercise activity. You should wear your compression garment while you are exercising.

  2. Sleeping position

    Please sleep on your back (flat or elevated) or part way over (pillow under your shoulder and hip). Do not sleep on your side until about 3 weeks after surgery. Unless otherwise instructed by Dr. Friedman, do not sleep on your stomach until about 8 weeks after surgery.

  3. Incision care

    You have Steristrips (butterfly tapes) over your incision. After these peel off (about 2 weeks after surgery), begin scar massage with Mederma twice daily. Mederma is available at our front desk or over-the-counter at your pharmacy. If you prefer, you may use Vitamin E or Aloe Vera. Continue scar massage for about 3 months.

  4. Massage

    You should begin massage to the suctioned areas one week after surgery. This will help smooth any irregularities and areas of firmness. You may apply lotion to your hand to massage and/or you may use a vibrating massager. If you would like, we will provide you the phone number of a licensed massage therapist.

  5. Water exposure

    You may begin light showers 3 days after surgery. You should avoid scrubbing your incisions. Avoid the pool, lake, and ocean for 4 weeks.

  6. Medications

    One week after surgery, you may resume use of any medications or supplements that you discontinued prior to surgery. However, for at least 3 weeks, you should avoid Motrin, aspirin, and any other product that may thin your blood.

  7. Smoking

    Do not smoke for at least one month (and preferably much longer) after surgery. Smoking may increase your risk of infection, lung problems following anesthesia, and wound healing problems.

  8. Tanning

    You may tan whenever you like. However, you should use a high-SPF sunscreen (30 or greater) over your incisions for at least 6 months. Premature tanning of the incisions may cause them to darken permanently.

  9. Compression garment

    Wear the compression garment all day and all night (except for showers and massage) during the first month. You may gradually taper your use of the compression garment over the second month. If you have had liposuction of the thighs or knees, you may wish to wear elastic support hose for a few weeks to prevent ankle and foot swelling.

  10. Sex

    You may resume intercourse with the compression garment in place 2 weeks after surgery. You may resume intercourse without the compression garment 4 weeks after surgery.

Please feel free to ask Dr. Friedman or his staff about any additional questions or concerns.

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Plano Liposuction

When diet and exercise are not producing the desired results, many men and women often turn to plastic surgery. At the West Plano Plastic Surgery Center, Ronald M. Friedman, M.D. offers liposuction surgery, a cosmetic procedure designed to help patients achieve slimmer, better-contoured shapes. At his surgical center, located on campus at the Presbyterian Hospital in Plano, liposuction patients may anticipate the utmost in personal care.

How is liposuction performed?

Although designed to eliminate stubborn, localized pockets of fat from various areas of the body, liposuction ("lipoplasty") is not a means of weight loss; rather it is a surgical technique used to improve body contour. The best candidates for this procedure have excess fat that does not respond to dieting and exercise, are at a relatively normal, stable weight, and have firm, elastic skin that can retract smoothly following the procedure. Liposuction is not designed to improve skin tone, and it will not reduce the appearance of dimpled skin (cellulite).

Irving liposuction surgeon Dr. Friedman prefers the "superwet" technique, which involves injecting a diluted fluid containing lidocaine (local anesthetic) and epinephrine (adrenaline) to the target area. He then uses a hollow metal tube ("cannula") that is attached to a vacuum source for the removal of unwanted fat. By moving the cannula back and forth in the target area, Dr. Friedman is able to remove pockets of unwanted fat. Plano, Irving and Frisco liposuction patients may also benefit from Dr. Friedman's artistic background as a sculptor when undergoing liposuction in Plano, Texas.

Prospective Plano and Frisco liposuction patients often target the chin, arms, abdomen, hips, "love handles," thighs, and knees. Men who have enlarged breasts ("gynecomastia") may also benefit from liposuction. Dr. Friedman will recommend the most appropriate body contouring method for each patient. Liposuction is also frequently done in conjunction with "Mommy Makeover" surgery.

Irving, Frisco, and Plano liposuction surgery patient results may be viewed in before and after liposuction photos. Educational videos, patient testimonials, and the provided Q&As offer further insight on various procedures available at the West Plano Plastic Surgery Center.

Ronald M. Friedman, M.D. - Plano Liposuction Specialist

Board certified by the American Board of Plastic Surgery (ABPS), Dr. Friedman is also a member of the American Society of Plastic Surgeons (ASPS), the Texas Society of Plastic Surgeons (TSPS), and the American Society for Aesthetic Plastic Surgery (ASAPS). He is the former Chief of Plastic Surgery at Parkland Memorial Hospital, and has earned multiple awards during his 15 years of experience. Dr. Friedman has been named "Best Plastic Surgeon" in D Magazine, a "Texas Super Doctor" by Texas Monthly magazine, and has made various media appearances, including multiple interviews by

Those in the Frisco, Plano, and Irving areas interested in liposuction may schedule a complimentary cosmetic consultation at either location, Plano or Flower Mound, by calling (469) 467-0100. Prospective patients may also fill out a contact form or send an e-mail.

© 2018 Ronald M. Friedman, M.D., P.A.

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