Liposuction Los Angeles, CA
Dr. Kenneth Hughes, MD in Los Angeles Performs Hundreds of Liposuction and Liposuction Revision Procedures Each Year
Dr. Kenneth Hughes, MD, Harvard-educated, Harvard-trained board certified plastic surgeon, has performed thousands of liposuction and liposculpture procedures for his very satisfied patients in the Los Angeles and Beverly Hills areas and for his patients from around the world. About 50% of Dr. Hughes’s patients venture from other states or countries to seek his expertise. Dr. Hughes performs a wide array of liposuction and liposculpture procedures (including liposuction 360 or 360 degree liposuction), complex liposuction procedures, complex revision liposuction procedures, or liposuction procedures in combination with other procedures in his brand new surgery center in Los Angeles.
Understanding the Liposuction Procedure
The liposuction or liposculpture procedure involves making a few small (4 mm) incisions through which instruments called cannulae are inserted to remove the fat in a very precise fashion. Liposuction is a blind procedure in which haptic and proprioceptive feedback must be mastered by the practitioner to create the most pleasing result, in which the flap is smooth. The pressure generated from an intraoperative vacuum results in the ability to avulse fat from the body with these cannulae, which have small holes at the end of the cannula for removal. The holes can be oriented differently based upon application. The cannulae can vary in length, but 30 cm or less is more common for this procedure. Dr. Hughes only uses blunt liposuction tips to minimize the risk of intraoperative puncture or damage to underlying organs. This is particularly important in revision cases, wherein previous surgeons may have created multiple, aberrant tracks and scar tissue, which create more possibilities for deviation.
Dr. Hughes, respected liposuction surgeon, uses small cannulae of 2, 3, 4 or 5 mm in diameter to allow for a more precise fat extraction and sculpting. Any area of the body can be sculpted including abdomen, flanks, back, medial thighs, lateral thighs, upper arms, and chin. The areas are sculpted as the patient desires. Please look at the liposuction before and after photos to see some of the dramatic transformations performed by Dr. Hughes in Los Angeles and Beverly Hills.
Type of Liposuction Not Important, Surgeon’s Skill in Liposuction IS KEY
Many varieties of liposuction are available including ultrasonic, smart lipo, laser liposuction vaser lipo, power assisted liposuction, and conventional tumescent liposuction. The results depend very little on the method used and very much on the surgeon selected. Dr. Hughes, a true liposuction master, prefers conventional tumescent liposuction with small cannulae to produce the finest result. The energy components of other methods can lead to unsightly skin changes and burns that cannot be corrected. Dr. Hughes sees at least 2 patients a week who have skin changes from these types of liposuction and there is literally nothing that can be done about the cobble-stoning or color variegation that occurs as a result of the burning of the tissues. The energy in the form of heat destroys the fat cells and surrounding tissue and can render the surrounding tissue incapable of being used for fat transfer procedures.
The final common pathway for any liposuction procedure is removal of fat with a cannula. The cannula is attached to suction tubing which is able to extract fat through suction generated by a suction vacuum. The cannula can have one or many holes in many orientations. Blunt cannulae are used to reduce the risk of inadvertent puncture of deeper structures.
Every day, a new purported better way of performing liposuction is heralded by a company or the media. The truth is that there is very little difference in the various modalities. Some of them report that there is more skin tightening but a higher chance of burn. Dr. Hughes deals in the scientific realm where studies must demonstrate definitive skin tightening to merit the risk of burns. Previous modalities have been less than impressive in their demonstration of results of contraction or skin tightening. However, the risk of large surface area third degree burns is present in many of the older and newer modalities.
All of these older types of energy based technology are delivered in unipolar fashion, in other words energy is dispersed from a single pole and the energy dissipates outward in all directions. This type of delivery is inefficient and produces little to no retraction (no noticeable tightening of the skin). In addition, the risk for burns is much greater due to the uncontrolled emanation and dispersion of energy into surrounding tissues.
Important Factors to Consider Prior to Your Liposuction Procedure with Dr. Hughes
Patient should not be smoking. Patient should not have heart or lung disease. Patients with diabetes, or hypertension should be well controlled and optimized for surgery. Patients should be evaluated for hepatitis Cand HIV.
Patients with a history of clots in their legs or history of clots going to their lungs may need medications to “thin” the blood or these patients may not be surgical candidates.
Use of birth control pills or hormone replacement therapy increases the risk of blood clots and patients may be advised to stop taking these one month prior to liposuction.
Medications such as aspirin, nonsteroidal anti-inflammatory agents like Ibuprofen and Naproxen, vitamin E, should be discontinued 2 weeks prior to the liposuction procedure,
Patients who are significantly overweight (BMI greater than 30 or 35) have a higher risk for poor wound healing, infection, and blood clots, and candidacy of these patients should be evaluated on a case by case basis.
Some patients have a lot of intra-abdominal fat, which is not addressed by liposuction only weight loss.The patient must have adequate skin elasticity to allow for skin retraction after surgery. This factor is the most important element to good results aside from technical proficiency of the surgeon and the patient’s ability to follow the postoperative regimen of wearing the compression garment appropriately.
Dr. Hughes will point out any wrinkles, laxity, and surface irregularities, including dimpling. Dr. Hughes will endeavor to improve these items during the surgery through a series of maneuvers. However, the improvement will only be partial.
Cellulite is often noted in areas such as the hips, buttocks, or thighs. Cellulite is predetermined by genetics, so even thin women can develop the appearance. Patients should be aware that liposuction procedures do not address cellulite and may in fact worsen its appearance. Dr. Hughes will try to correct any dimpling or asymmetry. However, this is frequently difficult to achieve. The patient should be aware of possible persistent asymmetry, depressions, and dimpling after the liposuction procedure.
Larger Volume Liposuction up to 5 Liters with Dr. Hughes in Los Angeles
Dr. Hughes has extensive experience in larger volume liposuction surgeries of up to 5 liters, the safe maximum amount that can be liposuctioned out in an outpatient setting. While less volume can be liposuctioned safely, the less of the fat that is liposuctioned the less of a change in body form that is produced. And no patient wants to go through two or three surgeries when one surgery would have sufficed. In fact, about 80% of Dr. Hughes’s practice is comprised of liposuction revision cases, which are very challenging. Sometimes more liposuction is needed. Sometimes fat grafting is needed, some times skin tightening can provide the improvement necessary, and sometimes skin removal is needed. Frequently, Dr. Hughes, the Renaissance plastic surgeon, uses all of these modalities to allow for the best possible correction in these complex liposuction revision cases.
Using the Liposuctioned Fat to Transfer to Other Areas: Butt, Breast, Face, Calves
In addition, Dr. Hughes can use some of the liposuctioned fat to augment and fill facial areas due to aging (facial fat grafting procedure). He can also use the liposuctioned fat to create larger, shapelier buttocks and hips (Brazilian butt lift procedure). Dr. Hughes performs hundreds of Brazilian buttlift procedures each year in addition to the hundreds of liposuction procedures he performs each year for his patients in Los Angeles and Beverly Hills.
Dr. Hughes’s Skill in Liposuction Helps Patients Avoid the Tummy Tuck Scar
In some patients, Dr. Hughes performs a large volume liposuction of 5 L of the front, sides, and back and can avoid a tummy tuck and its associated scar. Please see some of Dr. Hughes’s liposuction pictures for his patients of the Los Angeles and Beverly Hills areas. Dr. Hughes has now performed hundreds of skin tightening cases with Bodytite and Facetite and can dramatically reduce the need for skin excisional procedures for the abdomen, arms, thighs, bra rolls, lower back, buttocks, and knees.
Liposuction and Bodytite for Skin and Tissue Tightening: Accept No Substitute
Bodytite, which is the newest and most expensive tissue and skin tightening technology to date, is offered in lieu of these older technologies such as smartlipo, laserlipo, vaserlipo, etc. Though it has nothing to do with liposuction, Bodytite can be used in conjunction with liposuction on any part of the body (abdomen, sides, back, thighs, knees, arms, neck, buttocks, etc. Bodytite is the most sophisticated bipolar device available. It has two poles of energy dispersion which keep energy contained and focused between the two poles. Thus, the efficacy and efficiency is much increased. In addition, the energy is focused and not dispersed in unorganized fashion (which is what has led to large surface area burns in previous technology). Small burns may still occur with Bodytite but not the extent of the previous, less sophisticated technologies.
With the advent of BodyTite and FaceTite, the risk for burns is minimized, though not eliminated, and the published percentage of contraction is 40% (compared to 8 to 20% reported for other modalities). Once again, though, this is not just about the technology; it is the surgeon who is wielding the technology. Dr. Hughes performs this procedure through multiple different passes at different depths and from crossing and overlapping angles to create the smoothest result. Dr. Hughes, a master of Bodytite and Facetite as well, also uses the highest settings to produce the most contraction. If higher settings are not used, the contraction is not meaningful and the procedure is done with little benefit. Dr. Hughes exerts extreme care to avoid burns, but burns are a known complication of this surgery. However, the burns will not occupy a large surface area as was the case with some of the older technology.
What to Expect on the Day of Your Liposuction Surgery
The day of surgery the patient will come to the office about one hour before surgery to check in and sign remaining paperwork as necessary. Dr. Hughes will reiterate the operative plan and any additional questions will be answered and additional concerns will be addressed. The nursing staff and board certified anesthesiologist will perform additional history and physical assessments to assure optimal patient health and safety. Sometimes patients will be asked to obtain medical clearance in addition to routine lab or blood work prior to surgery and this will be reviewed as well.
The liposuction surgery may be performed under local anesthesia for smaller areas or less involved surgeries. Areas that involve more fat removal or when multiple areas are to be liposuctioned, general anesthesia is usually more comfortable for the patient and allows for the most precision on the part of the surgeon.
The surgery itself usually lasts between 30 minutes and 3 hours based upon the number of areas that are to be liposuctioned and the relative complexity of the procedures. The patient usually remains in recovery for 1 or 2 hours as they awaken and assessed appropriately prior to discharge.
LIPOSUCTION FOLLOW-UP and RESULTS with DR. HUGHES
Dr. Hughes, recognized as one of the best liposuction surgeons in Los Angeles, typically sees out-of-town patients prior to departure from Los Angeles and he sees local patients from Los Angeles, Beverly Hills, etc. in about 1 week. Dr. Hughes will assess at follow-up if the garment is being worn correctly and if postoperative instructions are being observed accordingly.
Dr. Hughes will then usually follow-up with patients at 4 weeks and at 3 to 6 months. If there are ever any issues with healing, Dr. Hughes can be contacted through both email and by calling the office. Patients may not realize the full results from liposuction until 6 months or longer. Please do not worry about lumps or bumps or areas of hardness as this is just part of normal healing. Dr. Hughes will always determine if you have a seroma or fluid collection that should be drained. This is the number one complication that can ruin a liposuction result and is the primary reason for the wearing of the garment for 6 weeks and the avoidance of exercise or strain for 6 weeks.
Although Dr. Hughes has extensive experience with suctioning larger volumes, it is of paramount importance that the patient follow postoperative instructions to the letter and that the compression garment is worn as instructed. A less than desirable result may occur when a patient develops massive fluid collections postoperatively or repeated small fluid collections, which will cause a wavy nature to the skin or wrinkles in the skin. When the proper postoperative regimen is followed, the risk for contour irregularity is exceedingly small. The reason for this is that Dr. Hughes, liposuction surgeon, will liposuction the subcutaneous fat as evenly as possible so that every area is liposuctioned to the exact same thickness with machine-like precision. Dr. Hughes’s physical gifts and prowess really pay big dividends for patients who are looking for dramatic results as liposuction is an extremely labor intensive surgery, so labor intensive that many surgeons will give up before optimal results are obtained. Dr. Hughes will not give up on you, and he never leaves the operating room until your best result is achieved.
The typical liposuction patient can go back to work in a week’s time, while wearing the compression garment for the first 4 to 6 weeks. Strenuous exercise can usually be resumed in 6 weeks. For more information, see the articles below.
Complications of Liposuction Surgery
Patients with a higher body mass index have been found to have a significantly increased risk for developing postoperative seromas as have smokers. Ultrasound-assisted liposuction has also been associated with a slightly increased risk of seroma formation. Dr. Hughes does NOT use ultrasound-assisted liposuction. A well-fitting compression garment must be worn 24 hours a day 7 days a week for 4 to 6 weeks following surgery.
Simple aspiration is the most common treatment for a seroma. An implantable catheter or drain can be used to avoid repeated aspiration.
Burns have also been associated with ultrasound-assisted liposuction, as the ultrasound cannula can become very hot, and prolonged contact with the skin may result in skin damage. This has also been well reported with laserlipo, smartlipo, vaserlipo, and others. Dr. Hughes does NOT use these types of liposuction.
Infections are uncommon after liposuction, and you will be prescribed perioperative antibiotics to minimize the risk of infection.
The most common postoperative issue of liposuction is contour irregularity. Because contour irregularities may be secondary to postoperative swelling and skin elasticity, they may be treated conservatively for at least 6 months after the initial operation. However, secondary liposuction, fat grafting, and tummy tuck can be considered to address the persistent areas of concern.
Skin hyperpigmentation may be attributed to several factors. Hemosiderin deposition by ecchymosis, external pressure from bandages applied, and possible friction from the inlet holes of the cannula have been suspected of increasing the likelihood of hyperpigmentation postoperatively.
Patients may experience paresthesias after surgery. Patients have reported hypersensitivity and numbness after surgery that may persist for weeks or months, but these usually resolve.
Deep venous thrombosis (blood clot in the legs) with possible pulmonary embolus (clot migrating to the lungs) as well as fat embolus represent possible risks of liposuction.
Deep venous thrombosis may be present with calf or leg pain, swelling or redness of the lower extremity, persistent elevated heart rate, and/or mild fever. Treatment of deep venous thrombosis may entail anticoagulation or placement of a venous filter.
Patients with pulmonary embolus may present with shortness of breath or chest pain. Treatment may include thrombectomy, thrombolysis, or anticoagulation. Although the exact pathophysiology of fat embolism syndrome remains somewhat controversial, signs or symptoms of fat emboli after liposuction surgery require immediate care.
Pulmonary embolus or fat embolus may occur at a rate less than 0.1%.
Advances in the understanding of fluid management in the care of the patient undergoing liposuction has increased the margin of safety of this procedure. The key to appropriate perioperative fluid homeostasis is proper patient selection and consistent communication between the surgeon and the anesthesiologist. In addition, with current tumescent techniques of liposuction, blood loss has been reduced to 1% of the total lipoaspirate.
Internal organ damage from the liposuction cannula has been reported as well.
Before and After Liposuction Photos of Dr. Hughes in Los Angeles
Dr. Hughes, master liposuction plastic surgeon in Los Angeles and Beverly Hills, will put his Harvard credentials and elite skills to work for you. Please view the hundreds of liposuction before and after photos to familiarize yourself with the results you can anticipate.
Best Liposuction in Los Angeles and Beverly Hills with Dr. Hughes
BEFORE & AFTER GALLERY
Dr. Kenneth Hughes, MD has performed thousands of liposuction and liposculpture procedures for his very satisfied patients in the Los Angeles and Beverly Hills areas and patients around the world.
View Articles written by Dr. Hughes, Harvard-educated, Harvard-trained, board certified plastic surgeon:
Article 1: Overview of Liposuction
Article 2 : History and Physical for the Liposuction Patient
Article 3: Types of Liposuction Available
Article 4 : Complications of Liposuction
Article 5: Complications of Liposuction 2
Article 6: Postoperative Management in Liposuction
Additional reading on Liposuction with Dr. Hughes in Los Angeles and Beverly Hills
All articles are written by Dr. Kenneth B. Hughes, MD
Harvard-educated, Harvard-trained, Board Certified Plastic Surgeon in Los Angeles
- Is Your Surgeon a Liposuction Expert? How Do You Know?
- Liposuction Safety and Risks
- Why Liposuction of Foreign Material Injections of the Buttocks Does not Work
- Sometimes the Best Liposuction Revision Involves Neither Liposuction Nor Fat Grafting
- Dr. Kenneth Hughes MD Discusses Risks of Liposuction & Prevention of Complications
- What Liposuction Can Do and What It Can’t
Commonly Asked Questions about Liposuction:
1) Can liposuction Be Combined with Other Procedures?
Yes. Liposuction can be combined with breast surgery, tummy tuck, rhinoplasty and almost any other procedure.
2) What is Aggressive Liposuction?
This term just refers to making the most of the procedure and getting you the best result. Dr. Hughes, honored as one of the best liposuction surgeons, will not give you the results that are seen so often when one cannot tell the difference between the Before and the After Picture. The result will be significant and, if you want, dramatic.
3) What method of liposuction does Dr. Hughes employ?
Dr. Hughes uses small cannula, tumescent liposuction without heat sources. In this way, Dr. Hughes avoids burns that have become quite common with Smart Lipo and other liposuction methods.
Liposuction and Liposuction Revision Videos with Dr. Hughes in Los Angeles and Beverly Hills
PREPARING FOR SURGERY
- STOP SMOKING: Smoking reduces circulation to the skin and impedes healing. It is best to avoid smoking, second hand smoke and cigarette replacements, such as nicotine patches or gum, in the perioperative period. While you should ideally stop smoking for 2 weeks before and after your surgical procedure, YOU MUST NOT SMOKE FOR A MINIMUM OF 24 HOURS BEFORE AND 24 HOURS AFTER SURGERY.
- TAKE MULTIVITAMINS: Start taking multivitamins twice daily to improve your general health once you have scheduled your surgery.
- TAKE VITAMIN C: Start taking 500 mg of Vitamin C twice daily to promote healing.
- START TAKING AN IRON SUPPLEMENT: A good iron supplement, such as Feosol, is required starting one week before surgery and four weeks following surgery. Bowel movements may appear darker than usual as a result. Feosol is available without prescription.
- DO NOT TAKE ASPIRIN OR IBUPROFEN: Stop taking medications containing aspirin or ibuprofen. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).
- LIMIT VITAMIN E: Limit your intake of Vitamin E to less than 400 mg per day.
- FILL YOUR PRESCRIPTIONS: You will be given prescriptions for medications. Please have them filled BEFORE the day of surgery and bring them with you.
- CONFIRM SURGERY TIME: We will call you to confirm the time of your surgery. If you are not going to be at home or at your office, please call us to confirm at (310) 275-4170.
- PRESCRIPTIONS: Make sure that you have filled the prescriptions you were given and set the medications out to bring with you tomorrow. Make sure to have the number for your pharmacy ready so that if Dr. Hughes and associates need to call in any special medications for you on your day of surgery they will have that information readily available.
- CLEANSING: The night before surgery, shower and wash the surgical areas with an antibacterial soap such as Dial, Safeguard, pHisoHex, or Phase II I.
- EATING AND DRINKING: Do not eat or drink anything after 12:00 midnight except for a small amount of water to rinse your mouth while brushing your teeth.
- SPECIAL INFORMATION: Do not eat or drink anything! If you take a daily medication, you may take it with a sip of water in the early morning.
- ORAL HYGIENE: You may brush your teeth but do not swallow the water.
- CLEANS ING: Shower and wash the surgical areas again with an antibacterial soap such as Dial, Safeguard, pHisoHex, or Phase Ill.
- MAKE-UP: Please do not wear moisturizers, creams, lotions, or makeup.
- CLOTHING: Wear only comfortable, loose-fining clothing that does not go over your head. NO TIGHT PANTS. Remove hairpins, wigs, and jewelry. Please do not bring valuables with you.
- CHECK IN/PREPARATION: Surgery Time:
- You should plan to arrive 45 minutes earlier than your scheduled surgery time. Patients less than 18 years old must be accompanied by a parent or legal guardian. When you arrive at our office on the day of your surgery, give the receptionist the phone number of the pharmacy you would like us to call for any special medications Dr. Hughes and associates might prescribe.
- CARETAKER: Someone must spend the first night after surgery with you.
LIPOSUCTION POST-OP INSTRUCTIONS
- The first week you will need to rest frequently. You need to walk around the house as tolerated. Avoid stairs if possible.
- You may sleep in the position you find comfortable.
- Avoid picking anything up greater than 5 lbs for 4 to 6 weeks.
- Do not exercise or do anything strenuous for 4 to 6 weeks.
- You may not drive the first week or while you are taking pain medication. After that it will depend on your ability to handle a car without causing any discomfort. You should wear your seat-belt at all times.
- Do not engage in sexual activity at least 4-6 weeks after your surgery.
- No smoking. This will interfere with your healing.
- Eat light the first 24 hours, clear liquids advancing to a regular diet as tolerated.
- Make sure protein consumption is at least 100 grams per day to assure appropriate healing.
- The pain medicine may cause constipation. Drink plenty of fluids. You may take any over the counter laxatives or stool softeners as needed.
- You will have abdominal binder over your abdominal dressings. Change dressings as needed. YOU SHOULD WEAR THE BINDER 24-7 FOR 6 WEEKS, ONLY REMOVE FOR SHOWERING.
- It is normal to have numbness over the surgical sites for several weeks or months.
- Do not use a heating pad or ice around the surgical sites. It could cause a burn.
- You may shower the following day, place new dressings, followed by same foam and put same garment as instructed, making sure to have garment covering pubic area.
- It is normal to see lots of drainage on abdominal dressings. Do not be alarmed at the amount of drainage as Dr. Hughes sometimes places several liters of tumescent fluid to perform the surgery and this fluid must either be absorbed by or drain from the patient.
- When drainage has stopped replace dressings with a T-shirt keep using the foam and garment as previously instructed.
- Take your antibiotic until it is completed.
- If the pain medication is a narcotic it should be taken as prescribed. Do not take any Tylenol while on pain medication. The medication we prescribe may already have Tylenol in it.
- Do not drink alcohol or drive a car while taking pain medication.
- The pain medication may cause nausea and should be taken with food at each dose.
- You may resume your regular medication after your surgery except for Vitamin E, Fish oil and Aspirin (wait at least 2 weeks post-op).
- If you take aspirin or coumadin check with the doctor to see when you may resume them.
CALL THE OFFICE IF YOU HAVE:
- A temperature greater than 101 degrees.
- A sudden increase in drainage, pain, or swelling around the incision site or the surrounding area.
- If you have persistent vomiting.