The principles of correction are simple. their execution is more difficult.
Klapper MD
Waves and Cobble stoning
While working close to the skin only a fine cannula should be used. With a fine cannula the areas of cobble stoning should be aspirated ( Secondary Liposuction ).
Depressions and Divots
It makes sense that if we cause a depression from over resection that we should return volume in the form of Fat Grafts to fill it.
- You must have an area of fat that can be harvested.
- Prediction of the survival of a fat graft is inexact and must be built into the procedure.
Scientifically we know that only 40-60% of the fat placed will live
i. we must overcorrect these areas accordingly
ii. we may need additional fat grafting and revision to achieve our final goal
- Liposuction creates scars inside your body that should be released
Asymmetry
A determination must be made if an area is asymmetric do to over or under resection or a combination. Fat should be grafted and aspirated accordingly.
Burns
span class="bodystyle">Full thickness burns from liposuction that have sought out consultation with Dr. Klapper usually are coupled with other deformities and show a lack of understanding of the technical aspects of ultrasonic liposuction. They occur within the aesthetic unit being liposuctioned and can be quite deforming. Conservative burn scar management consisting of compression, silicon sheet or gel, steroids and a multitude of Cosmeceutical salves. In general operative management can replace one scar for another and should be sought only in consultation with a Board Certified Plastic Surgeon. A few examples of Creative Options include:
Lower Abdominal Scars - Treatment: Abdominoplasty
Upper Abdominal Scars - Treatment: Reverse Abdominoplasty
Creative solutions may exist for different aesthetic areas and can only be determined in consultation.
I suggest you follow this checklist:
- Determine Board Certification
- Even if someone calls himself or herself "Board Certified" determine if it is a board recognized by the American Board of Medical Specialties. This is the main governing body for medical specialists. If your doctor is not a Diplomat of one of these Specialty Boards be concerned.
• i. To read more about what if means to be Board Certified http://www.abms.org/Downloads/Monthly_Articles/Board_
Certified.pdf
- http://www.abms.org/ here you can see if your surgeon is board certified. If they are not found here be very concerned.
- Did your surgeon's residency training programs consider this procedure as part of their core curriculum?
- Did your doctor learn this procedure in a postgraduate training course such as a weekend symposium? If so only you can determine if you have confidence in such an individual.
- Where will your liposuction be performed?
- Hospital
- Ambulatory Surgery Center
- Office Operating Room
i. Be sure that you are to operated in a facility that is certified to the same standard as a hospital operating room and that the surgeons operating there have privileges to do the procedure in a hospital:
• AAAASF : http://www.aaaasf.org/
• JCAHO : http://www.jcaho.org/
- Which hospital will you be admitted to in the case of a complication? Does your doctor have admitting privileges there?
- Who pays for touch ups and redos?
- Price: This is my personal opinion and should be regarded as such:
- You only have one body and one life
- If it is not done right the first time it will cost you much more down the road to fix it.
- Stay away from outliers:
• i. Do not equate high expense with the quality of a surgeon's result
• ii. There is usually a range of prices for a procedure in a geographic region. There is a midrange that most surgeons fall into and then there are outliers on both extremes.
• iii. Be careful of the lowball price as many times you get what you pay for.
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