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8550 Datapoint, Ste 110 :: San Antonio TX
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8715 Village Drive, Ste 504 ::
San Antonio TX 78217 ::
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Ask Dr. Coleman
Liposuction
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Dr.
Coleman's Comments:
The
technique of liposuction has changed very little since it's beginnings
in the 1980s. The one true contribution to the art came more than
ten years ago when the Tumescent Technique was popularized. This
was invented by a dermatologist, and basically involves the use
of large amounts of dilute anesthetic and epinephrine instead
of small amounts with higher concentrations. In contrast to claims
by some doctors, this is not a new development. I have been using
the tumescent technique since 1992. The larger amount of fluid
distends the tissues and actually improves the accuracy of the
liposuction. It also reduces blood loss to a bare minimum and
replaces fluids that are normally lost in the operation. Its safety,
even with large amounts, led many non-surgically trained physicians
to practice this in their offices instead of in an accredited
and medicare certified surgical facility.
Although few accidents happened, deaths have occurred due to the
lack of training in surgical principals and experience in evaluating
and treating fluid balances. Deaths have also occurred because
physicians lacked the training to recognize blood losses. This
is compounded by office facilities that lack the appropriate monitoring
and resuscitation equipment.
When small areas are being treated, the surgery is very safe.
When larger amounts are being suctioned, it is best to have doctors
who have completed full surgical residency programs and who have
privileges in an accredited hospital operating room or surgical
facility to do these procedures.
I
have completed a full five year residency program in general surgery.
I served as Chief Resident in a busy trauma hospital and received
extensive training and experience in critical care before I started
my additional two years in an accredited nationally acclaimed
plastic surgery residency. In 13 years of plastic surgery practice,
I have not had one life threatening complication in spite of many
major large scale reconstructive procedures.
A
Word about Modern Techniques
The
1990s brought in many new products in an effort to improve on
the art of liposuction. The most important is ultrasound assisted
liposuction. This is added to the regular technique by use of
a cannula that vibrates at a high frequency and emulsifies the
fat making it easier to remove. This instrument is somewhat bulky
and requires a larger incision to fit the tube. There is also
a reported instance of burns to the skin from holding it in one
place too long, or suctioning too close to the skin.
Another tye of ultrasound is given by means of a "wand",
which is rubbed over the skin prior to liposuctioning. This has
a safer track record.
In spite of these two instruments, there are many specialists
who feel that in the long term, they do not really improve the
final result with the exception a few special instances. Several
photo comparisons have been done by recognized authorities and
many could not tell which patients had ultrasound and who did
not.
I will continue to follow these trends, but for now, I do not
offer ultrasound. It is more expensive to the patient and in my
hands, hasn't proven to change my results.
See
How It's Done - Demo
Patient
Photos:
Breast
Liposuction
Chin
Liposuction
Hip
and Thigh Liposuction
Thigh
and Knee Liposuction
Waist
Liposuction
Additional
information from the American Society of Plastic Surgeons
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