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Dr. Dean Kane – “Fat Chance”

My patients are well educated on the differences between liposuction and tummy tuck. For those who remain confused, liposuction removes fat of the face, neck, trunk arms and legs;  tucks remove primarily the skin of the face, neck, tummy, back, flanks, arms and thighs.

Liposuction and its artistic cousin liposculpture is the removal of deep under-the-skin fat; essentially deflating the thicker outer layer of the body.  Our skin is layered into two layers of living “hide”, the epidermis and the dermis and two layers of fat with a tough membrane called fascia in-between. The more superficial layer of fat is generally thin (about 3 to 10 mm thick) and metabolically stable. The superficial subcutaneous layer maintains a insulating, constant, smoothening and protective sheet of fat just below the dermis. The deeper subcutaneous fat is  variable and metabolically much more active. The other storage area for fat is deep to the subcutaneous fat in the abdominal compartment. This fat is called visceral or organ fat. Fat is created and stored by genetic and environmental signals. Interestingly, during caloric weight gain AND starvation, the hormone insulin converts excess calories into fat which is stored in cells. So, when fat (cells) are sucked out by liposuction or cut out with a tuck, they are permanently removed. After surgery inflammation and water weight are lost within 3-6 weeks and your residual weight is your new weight….. for that moment. This is a great time to learn and integrate a new lifestyle of diet and exercise to reduce calories as new additional calories will be reformed and redistributed into other subcutaneous or visceral fat stores and your weight rises once again. In one of my next blogs, I will review how simple it is to have control over a lifestyle of exercise and diet! Where does the new fat go? Fat is remade and stored in the next more metabolically active areas of the body. Many patients redistribute this fat to their breasts or butt, arms or hips and thighs. If these areas have also been lipocontoured and particularly with men where these above areas are metabolically passive, fat is stored around the viscera, the heart, liver, stomach and intestines. Such visceral fat, ie the apple shape of men, is also associated with increased disease of the heart and blood vessels. Some patients experience a sense of tightening or bulking of the skin and this is thickening of the superficial fat layer. What was gained by liposculpture or a tuck, then? For many, the motivation of a relatively quick weight loss and new body contour is a jump start to the new lifestyle they were seeking. For others genetically disposed to have a pear shape like their mothers, the new profile for fitting in active, sexy and balanced clothing is enlightening! Non-invasive and less- invasive techniques are being considered by patients. Well folks, caveat emptor, buyer beware…. these newer techniques of external ultrasound, radio frequency, heat, laser, light and freezing devices or internal ultrasound, radio frequency and laser perform have no greater performance and provide less value for the consumer for the added cost of the machines.  You must still add a lifestyle modification to reduce calories and change your metabolism to optimize and meet your goals. There are advantages to non and minimally invasive fat reduction such as convenience, reduction in risks but so far, dissatisfaction and cost are their main detractors. The external techniques generally target the superficial fat only and the internal procedures are surgical in nature with punctures or incisions reduce limited fat volumes. The marketed value of reducing or tightening skin and cellulite remain unjustified. See my next blog on how these devices work and why they can fit into your life. Call to schedule your consultation at 410-602-3322 or email Lauri@DrDeanKane.com
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