The part I like most about being a plastic surgeon is being able to make a meaningful change in people’s lives. While many people may see plastic surgery as a shortcut, it is really helping people solve problems they are unable to on their own. Whether that’s loose skin and rectus diastasis (muscle separation) after pregnancy, breasts that don’t fill out clothing or bathing suits in a way that gives confidence, or nowadays the large amounts of loose skin we are seeing from weight loss patients, these are problem that cannot be fixed without surgical intervention. Sometimes, however, these problems are more subtle. I see patients that are working out daily, follow carefully regimented diets, but still are left with stubborn fat pockets and are unable to achieve the muscular definition that they are working so hard for.
Thankfully, we now have an excellent solution for this: high-definition liposuction. Pioneered by our colleagues in South America, this is the new frontier of liposuction. Traditionally, liposuction was performed to achieve a uniform smoothness. While this can also lead to great results for many patients, for those looking to achieve a particularly athletic physique, HD lipo can further enhance the existing musculature to more sculpted, 3-dimensional appearance to the body.
How is HD Lipo performed?
With any liposuction, we inject numbing solution to the areas that are being treated. The first step after this is to perform VASER. This uses ultrasound energy to separate the fat cells to make it easier to remove (often referred to as “melting the fat”). While this is a very helpful tool, this is not what makes HD lipo unique. The HD component occurs during step 2, when the fat is removed using power-assisted liposuction. Prior to this step, the natural borders of the muscles must be carefully identified and marked. During this step, the fat is sculpted in a particular way to highlight the hills and valleys of the body. This creates natural shadowing and is done to highlight your own muscles, not create fake ones. This is often what is referred to as ab etching, a term I personally dislike as I think it implies drawing and creating fake abs. For the results to be natural and long-lasting, care must be taken to ensure it follows the natural lines, not an artificial grid. The final step is shrink wrapping the skin with a device called Renuvion, which uses helium gas that is heated with radiofrequency to heat and contract the skin.
Ok, all that science is great, but is it the right procedure for me?
Generally, the best candidates for this procedure are already at or near their goal weight and exercising regularly but cannot lose the final stubborn fat to get the muscle definition they’ve been working towards. After all, those last few pounds are always the hardest! Of course, a consultation where you can have a complete discussion as well as a physical exam with your surgeon is the best way to determine if it’s the right procedure to solve your problems and achieve your goals.
I’m a woman, and a six pack would look way too manly on me!
Like anything in plastic surgery, HD Lipo should be customized to your anatomy and goals. There are 3 levels of definition that can be performed. Mild or soft definition, which is primarily a very smooth appearance with soft shadowing above the belly button. Moderate definition is the most commonly requested definition in women. This has emphasis on the vertical lines above the belly button as well as the sides of the ab muscles, creating an athletic but still feminine appearance. Extreme definition involves sculpting individual muscles, showcasing the six pack and surrounding muscles. This is commonly requested by men as well as some women that want a very athletic appearance.
Does it last?
Removal of fat cells via liposuction is a permanent change to your anatomy. This means that if you were to gain weight, you will gain less fat in the areas that liposuction was performed. So any proportions that exist after the procedure should stay for the long term. However, gaining a notable amount of weight can cause some of the definition to wash out, even though it does hold up quite well. It is another reason that this surgery is meant for those with a pre-existing commitment to diet and exercise, rather than a shortcut to getting abs, because the absolute best results will happen in patients who amplify their results with continued healthy lifestyles after surgery.
What’s the recovery look like?
Recovery in generally about 2 weeks. Pain peaks in the first few days but in generally well managed with a multi-modal pain strategy. Swelling will peak a few days after surgery. This takes several months to go away so it is a process! It can take a while to see the results so be patient and let your body heal. We recommend compression garments and lymphatic massage early after surgery in order to help minimize the effect of the swelling, but regardless it takes time to get to the finish line. Generally, you will be out of the gym at least 2 weeks, then slowly ease back into it.
Can it be done without general anesthesia?
It is generally our preference to do these procedures with general anesthesia. It is more comfortable and allows the surgeon to do everything that needs to be done with no compromises to get the best possible result. Selected areas can be done awake with local anesthesia but for more extensive lipo 360 procedures, general anesthesia is typically a better option.
I’m still looking to lose weight. Should I do this before surgery?
Generally, it is best to be very close to your goal weight (within ~10 lbs) at the time of surgery for the best possible results. That way, we see exactly the amount of fat present, can more easily identify your muscular anatomy, and ensure you have skin quality that will lead to a great result.
High-definition liposuction is one of my favorite procedures. Sculpting and defining musculature is an art form, and lets your body be the canvas with a dynamic, long-lasting result. The keys to natural result is identifying and respecting your natural anatomy and, perhaps more importantly, identifying the right candidate for the procedure. For the right patient, however, it can be the final step to achieving the muscular physique you’ve been working so hard for but just can’t seem to full achieve on your own.
If this sounds like you, or you’d like to determine if you’re a candidate, I would love to meet you to discuss your goals, frustrations, and how this procedure might be the key to overcoming them! To book a complimentary consultation, please call the office at 212-249-0949, email us at info@neinsteinplasticsurgery.com, or book online from our homepage. I look forward to meeting with you and helping you clear that final hurdle!