- Press Release-

Research Reveals VASER Lipo® Yields Fat as Viable As Conventional Liposuction

LOUISVILLE, CO – According to a recent study conducted at the University of Pittsburgh, human fat harvested by VASER ultrasound-assisted liposuction (Sound Surgical Technologies LLC), is as viable as fat collected by conventional suction assisted liposuction, with nearly 80% volume retention.

The study, led by Dr. J. Peter Rubin, Associate Professor of Plastic Surgery at the University of Pittsburgh, is the first research to establish strong support for VASER Lipo as a collection method of choice for fat transfer procedures.

The study investigated tissue samples of a female subject who underwent lipoplasty of the thighs and flanks. Detailed cellular viability analysis was performed on tissues collected, each having undergone VASER Lipo and suction-assisted liposuction on the body area. The researchers found little or no difference at the cellular level between the treatments, concluding that VASER Lipo is just as effective in yielding viable fat cells as suction-assisted liposuction devices. Results at six weeks showed approximately 80% of the filtered fat survived by volume, regardless of the method of extraction. As a point of comparison, other studies have shown less than 5% of the water-jet assisted liposuction fat survived.

“The highly selective nature of ultrasound energy promotes increased fat viability, making it ideal for fat transfer procedures,” said Mark Schafer, Chief Technology Officer at Sound Surgical Technologies. “We believe this important research will pave the way for widespread adoption of VASER ultrasound-assisted liposuction as the preferred method for fat transfer.”

The study’s findings support recent physician feedback that the VASER Lipo System is the leading technology for fat harvesting and fat transfer procedures, with unrivaled body sculpting capabilities.

About VASER Lipo

The VASER Lipo System features gentle ultrasonic energy that uses sound waves to selectively target unwanted fat.  The FDA-cleared device uses small probes that emit ultrasound energy to gently break apart fatty tissue for easy removal without destroying the fat cells themselves.  This means physicians can immediately remove, harvest and re-inject the fat to contour and augment other parts of the body, including the face, hands, breasts and buttocks.  The VASER Lipo System, one of the most respected body contouring technologies on the market, is the cosmetic enhancement tool of choice among top physicians who have patients who want both of these procedures in one appointment.

About Sound Surgical Technologies

Founded in 1998, Sound Surgical Technologies is a leading manufacturer and distributor of ultrasonic body shaping technologies, including the VASER Lipo which effectively treats all areas of the body and is clinically proven to enhance skin retraction, reduce blood loss, and maintain the viability of fat cells for fat grafting procedures. Physicians report smooth and consistent results with fast patient recovery. The VASER Shape MC1 and MedSculpt Systemsare an ideal complement to VASER Lipo, combining ultrasound and massage therapies to increase lymphatic and venous circulation, minimize postoperative pain and swelling, and temporarily improve the appearance of cellulite. All of the devices are FDA-cleared for use in the U.S. To learn more, visit www.vaser.com.

Dr. Andrew Kaczynski took part in this study and is proud to offer VASER Lipo at Advanced Concepts in Plastic Surgery in Sacramento.

There is a disturbing trend in medicine where internists, family doctors, gynecologists and other specialists are offering to do plastic surgery procedures as a way of making a little cash, “on the side.”  Dermatologists and E.N.T. (ear, nose & throat) doctors are expanding into areas where they have little or no training.  Because of this, complications are escalating like never before.

I know someone who went in for a yearly checkup and found her internists now owned a roomful of lasers next-door and was promoting their use.  The largest liposuction clinic in my community is run by an internists and an emergency room doctor.  Family practice doctors are opening, “med spas.”   Some E.N.T. doctors are beginning to perform breast augmentation surgery and gynecologists are doing face-lifts. What’s going on?

A recent article in Plastic and Reconstructive Surgery by Matthew Camp, titled Who is Providing Aesthetic Surgery? A detailed examination of the geographic distribution and training backgrounds of cosmetic practitioners in Southern California put some insight into this question.

So what is going on?

Medicine is hard-pressed for fair reimbursement by health insurance companies.  Despite any statements to the contrary, it is likely going to get worse in the future.  More and more doctors will be attempting to supplement their income by offering plastic surgery procedures in which they have little or no training.

Plastic surgery is literally the only cash business left in medicine, especially if you include hair transplants, laser hair removal, varicose veins, and all noninvasive treatments under that umbrella.

Individual magazines devoted to different specialties routinely promote, “boosting your income by adding cosmetic services.”  Medical meetings also promote one-day workshops in different procedures and technologies.

Makers of cosmetic products and devices are actively promoting their goods to non-plastic surgeons as a way of expanding their markets.  Moreover, those that are not intentionally marketing to these doctors are none-the-less bound by law to sell to these doctors if the doctor orders from them.  This is because in California, a medical doctor has a license that entitles him or her to do anything they see medically fit in the office.  He can do brain surgery, heart surgery, or sex changes.  If something goes wrong, let the lawyers sort it out after the fact.  There is no restraint of trade for physicians.  Hospitals monitor doctors and only allow them to have privileges for those procedures in which they have actual training and/or certification.  This is why most of these practitioners who are expanding their offerings work only in their offices where they are completely unsupervised and unregulated.

The economic situation that is leading gynecologists to start offering facelifts is also placing very young plastic surgeons, just out of school, in a difficult situation.  Therefore, they are vulnerable to being scooped up by franchise corporations that have catchy names and usually offer one specialty procedure at what they suggest is a discount price that an established and experienced plastic surgeon cannot compete with. The reality is that in most cases they are at or very near regular market prices for these procedures.  These “McFacelift” shops or “LipoKing” franchises perform procedures with pressure on the doctors and staff to do as many per day and as fast as they possibly can.  To quote from the Camp article, “the development of aesthetic practices with individual providers are considered to be interchangeable and replaceable is becoming ever more prominent.”  This is particularly the case among the “medispas.” The practices are often named after a geographic location with the cachet of affluence such as Rodeo Drive, Beverly Hills or La Jolla.  In these practices, or perhaps better described as “mills,” the practitioners are employees of the corporate owner of the clinical facility and are pushed to produce revenue.  The divorce of the practice from the name of a responsible physician has the potential to have a profound impact on the doctor-patient relationship and how patients select a provider.

Therefore, as the Romans said, “caveat emptor;” Let the buyer beware. This is especially true in California since there is essentially no enforcement by the medical board, which has recently been stripped of most of its funding.  Many complaints and many bodies must pile up before anything will be done.  Any doctor can do virtually anything in his office and will not be stopped until there are large numbers of complaints or he kills or maims a patient.  It is amazing that we require such tight restrictions on many other fields such as airline pilots.  What is happening is the equivalent of allowing someone who knows how to fly a single engine plane to go ahead and sit at the controls of 747, bringing it down for a landing into a major metropolitan area without any training.  Do you want the professional airline pilot with a complete education or someone who had a one-day course in the 747 before he takes your life into his hands? On the flip side, I am a trained plastic surgeon who has had thousands of hours of training and experience in plastic surgery but I have also had some training in many other aspects of medicine.  Legally, I can perform brain surgery and heart transplants in my own operating room, but would I be your best choice if you needed these procedures?  What if I were to offer to do the surgery at a discount?  …Yeah, I didn’t think so.

If you’re considering a plastic surgeon, do what the caterpillar did.  Ask, “who are you?”  “Are you board-certified?”  “Are you board-certified in plastic surgery?”  “How many of these procedures have you done?”  “How long have you been providing this procedure?”  “Do you have hospital privileges?  Or is plastic surgery just another way to boost your income.”  Or, “are you a cosmetic surgeon” which is essentially a meaningless term since there is no recognized Board of cosmetic surgery.

Caveat emptor. Do your homework and trust your gut feelings.  If you feel unsure or apprehensive, regardless of whom the person is, move on.  Plastic surgery is not like having your hair done.  Some people spend more time researching a vacation then researching a plastic surgeon, don’t be one of them.

Now, I do perform some plastic surgery procedures using local anesthesia pretty much every week.  A little scar revision, a facial contour in a small area, or a micro-liposuction on the face.  But most of the plastic surgery I perform at Advanced Concepts in Plastic Surgery in Sacramento are performed with sedation or with a general anesthetic.

First of all what is sedation? Sedation is when the patient has an IV and receives sedation medication through it but remains conscious.  There are several different kinds of drugs that put the patient in a particularly happy place.  This means you’re not completely asleep but you are also not aware of what’s going on, you are very comfortable and breathing without the help of a breathing machine.

So why would you not want to be aware of what is being done to you?  I’ll use myself as an example.  Several years ago I had a wisdom tooth erupt.  I guess I’m a late bloomer. I had it removed under local anesthesia only.  The dentist did a great job as I did not feel any pain.  But it was a very unpleasant experience with all the rasping, grinding and pulling.  In addition to that, my mouth and jaw was very sore from staying open.  So, how do you think I would have felt after two or three more just like that?  So let me state the case.  If I have to do that again, I just don’t want to know about it, and I assume my patients would rather not experience that kind of discomfort during their plastic surgery procedure either.

Where does strict local anesthesia work best?  Local anesthesia works in small areas and in a very limited short plastic surgery procedure.  When do you want sedation?  When doing a longer procedure with larger areas where they may still have feeling in spite of the local anesthesia, like scar tissue or when working under the muscle.  When you have a longer procedure it’s difficult to lay in one position for hours.  The local anesthesia may wear off and need to be freshened or it will become uncomfortable.  My goal for all my patients is to have everything as painless as possible on all levels.  When you do it under strict local anesthesia, there is always some amount of pain involved.

Another issue has to do with the regulations of surgery centers.  In California, if you do plastic surgery with sedation or general anesthetic, the facility has to be licensed by an agency that licenses surgery centers.  Currently there are two main ones AAAHC and AAAASF.  I actually do inspections for the latter.  When you pass inspection for unique standards of organization, cleanliness, accountability, and safety that means that your physical plant has been approved, it also means that you have hospital privileges for the procedure being done.  However if the procedures are under straight local anesthesia, you do not need to meet the strict standards of the physical plant or hygiene and safety accountability.

That certainly doesn’t mean that everyone promoting, “local anesthesia only procedures,” is doing it to avoid regulation of shoddy or dangerous conditions, but… let the buyer beware.

What about general anesthesia for plastic surgery procedures?  Even when using lots of local anesthesia some surgeries are very stimulating to the nervous system.  This is because local anesthesia blocks the pain stimulus but not necessarily pressure, pulling or heat.  One of the worst horror stories I’ve heard about local anesthesia revolve around a patient that had a breast augmentation under local anesthesia, with some sedation, and “woke up” in the middle of the procedure and was told to be still,” because we have to finish.”  They felt and  experienced much more than they wanted to.  Sometimes you need what is called muscle relaxation sedation to do what you need to do, i.e., put in a breast implant or suture up the abdominal muscles.  A light general anesthetic is perfect for a breast augmentation, mommy makeover or total facial rejuvenation such as a facelift because it keeps you perfectly comfortable for those longer procedures and often times actually requires less total medication and sedation.

In summary: straight local anesthesia is great for very small procedures. But IV sedation or   general anesthesia are better solutions for making the patient comfortable for many plastic surgery procedures.  My goal for the patients is a painless plastic surgery, and local anesthesia is not the best way to achieve  that in every case.

1. Vaser Hi Def – what is it? It is a completely new plastic surgery procedure.  Using Vaser technology in three dimensions: the chest, the back, the abdomen, arms and legs can be sculpted for the first time.  Despite claims that liposuction proponents have made, this is the first true liposculpture.  With liposuction in the past, the end result was the elimination of lumps and bulges, leaving a flat area where there used to be fat.  Now, with Vaser Hi Def, the true contour of your body can be brought out.  The Vaser probe selectively melts only fat unlike some other energy systems.  By differentially melting the fat in several different layers true sculpting can be achieved.
2. How much does Vaser Hi Def cost? Depending on the areas worked on this plastic surgery procedure costs from $7,000-$20,000.  It is roughly double the cost of regular liposuction.
3. Why is it so expensive?  Vaser Hi Def is expensive because of the very expensive equipment used, the extensive training and experience required to do it properly, and the time involved in the procedure itself, which is roughly twice as long as regular liposuction.  When you see the results it is actually very cost-effective.
4. Who is a candidate for Vaser Hi Def? The best candidates are men and women with a BMI (Body Mass Index) below 30.  This is not procedure for obese people or for people with very loose skin.  You are a candidate if you had six pack abs in the past and would like them back.  You are a candidate if you have spent hours at the gym for years and are making any progress in getting rid of abdominal fat.  You are a candidate if genetics, age and a lack of time are conspiring against you.  You are a candidate if you don’t want to take dangerous fat melting drugs or hormones that risk your health.  You are a candidate if you don’t want to spend all your free time exercising.
5. Will the effects last? The effects of Vaser Hi Def liposuction should last indefinitely assuming you maintain a reasonable weight.
6. What if I gain weight? If you gain weight, the effects should last through a 10 to 15 pound weight gain.  If you gain 30 or 40 pounds or more the effects will not stay and may even cause unsightly bulges.  It’s further motivation to stay in shape.
7. Will it hurt? Vaser Hi Def has some discomfort like any surgical procedure.  You will be given pain pills which will make your comfortable.  After a day or two most people are not taking pain medication.
8. How much time off work? Most people only need to be off work for seven to ten days.  After two to four weeks you can return to mild exercise.  After four weeks you can return to regular exercise.
9. Will any other treatment accomplished the same results? No.  Other treatments such as standard liposuction, Smart Lipo, Thermage, or abdominal etching will not achieve the same result as the three-dimensional process of Vaser Hi Def.
10. Where do I start? You start by making a consultation an appointment with me and have an evaluation and if you’re a candidate we can schedule your surgery.

Normal women have curves.  They also have bulges.  That’s where the problem starts.  Even at normal weights, some women have more bulges than they want.  For many women this is a shape that is heavy in the hips, buttocks and thighs, the typical pear shape.  Why do women accumulate weight in these areas?  Studies have shown that fat in these areas sustains women through breast-feeding and pregnancy.  It is fat specifically that provides energy for breast-feeding. Unfortunately in many cases, after the breast-feeding is over the bulges remain.

Many women have a pear shape even before pregnancy.  This is determined by your genes.  The French who invented liposuction called it genetic fat or diet resistant fat.  That is because this fat is the first to come on and the last to leave.  Women can be thin everywhere else and heavy in the hips and thighs.

Which brings us back to the genes.  With that type of shape, or even with the other difficult shape, the apple [heavy waist, thin legs) designer jeans simply don’t seem to fit in both the waist and thighs.

So what’s a girl to do?  Dieting doesn’t tend to work for genetic fat, neither does exercise.  Other plastic surgery options include Thermage, a non-invasive procedure, which besides shrinking skin can cause a decrease in inches in the waste and hips.  This is an outpatient single treatment that shrinks skin and gets rid of bulges with radio frequency waves.   For the best results, however, the gold standard for fat removal is liposuction.  The gold standard for liposuction is VASER.  An ultrasonic wave is used to melt the fat so it can gently be pulled out.  The results are that the bulges are gone.  So the genes that cause the problem are neutralized and those designer jeans finally fit.

How can something that looks like a Star Trek Tricorder, and shines a flashing red light that you can’t feel, actually do anything?  Well it does, and surprisingly well!  Scientists have known for a long time that light is biologically active.  Look at photosynthesis, how light creates energy in plants.  In a similar way, light creates energy in all of us in the cellular energy cycle.

The cool laser has a wavelength of 635 nanometers.  Don’t worry; you’re not supposed to know what that means.  This is a wavelength that is biologically active, that it influences the energy in our bodies.  It penetrates the cells and activates enzymes that increase something called ATP which is the energy currency of our body.  This also increases circulation decreases pain and suppresses inflammation.

On a practical level, every one of my patients is treated post-operative with the cool laser.  It works dramatically to decrease swelling, discomfort, and pain.  The healing time has been cut down in most procedures as well as the amount of pain medicines taken.  It is used for facial surgery, breast enhancement surgery, body contouring, and VASER Hi Def liposuction.

For many years in plastic surgery we were forced to ignored the back.  All the attention was on the front side: breast surgery in the text and a lot of liposuction was centered on the front – the mirror body that we see – the beach body.  But, what about the back?

Of course, there was liposuction on the hip area, also called the love handles.  This was done either with a tiny tech or other liposuction.  But what about the back and waste line? Was it ignored?  Actually, it wasn’t ignored.  It was difficult and inconsistent to get good results.  The back has different anatomy.  The skin is the thickest skin in the body.  The fat is fibrous and has lots of blood vessels, making surgery there much more likely to bleed.  In the past attempts to narrow the waste through the back and get rid of the bra line fat were difficult bloody and inconsistent.

The VASER changed that and VASER Hi Def liposculpture, which we offer exclusively at Advanced Concepts in Plastic Surgery of Sacramento, makes the back one of the best areas to do liposuction.  In the past I often had athletic patients in their forties, fifties and sixties who complained of a little excess in the back.  I considered that this was not fixable with the current technology and I didn’t do it.

Now with VASER Hi Def we can clean out the love handles narrow the waist, remove the bra bunching as well as extra fat in the lower armpit. We can recover a beautiful back curve either with or without a Brazilian butt lift.  The back curve is often lost with middle age and VASER Hi Def is the best way to get it back.

By doing all these things and being mindful of the artistic anatomy, we can bring back into the realm of procedures, so that it is possible to provide a circumferential rejuvenation of the torso.

#1. The BoTax.  The “BoTax” as it was referred to by the media was almost a part of the healthcare bill the Democrats hope to pass this year.  Basically it was going to be a 5% tax on all cosmetic surgeries: Botox, fillers and plastic surgery procedures   The  fact it was defeated is huge for the plastic surgery industry and patients.  It was wrong on so many levels.  It was the entry into the luxury/sin tax model regardless of the fact that most people using cosmetic services make less than $90,000 per year.  Privacy concerns would have been a huge issue and it would have been a logistical nightmare.  Doctors as tax collectors?  It also would have opened the door to other specific luxury taxes.  Why not Harley-Davidsons, golf clubs, massages, facials, etc.?  The possibilities are endless.  In addition the one place this actually was tried was in New Jersey and the plan just plain didn’t work and brought in nowhere near the projected income.  The only thing it really accomplished was increasing the numbers of surgeries performed in the state next door, New York.  I was very happy to see cooler heads prevail and the BoTax dropped from the healthcare legislation.

#2.  Fat is back.  Fat grafting has been around for over 20 years but was always treated as the poor stepchild of liposuction.  Because, in the beginning the results were variable so it was concluded that fat grafting was not scientifically consistent.  Over the years since there have been many more studies successfully supporting the science.  In addition, now there have been several reports that show that what is being transferred are actual stem cells in addition to the fat.  In fact, the stem cells may be the main source of what remains six months to a year later.  There is now more attention being paid since stem cells are the current darlings of scientific research.  There are even efforts being made to purify the stem cells out of the fat to increase survival of the fat cells.  In addition breast augmentation by fat grafting has become an accepted procedure and several investigators showed impressive results.  It’s not going to replace silicone breast augmentation nor is it for everyone.  This is because it is time consuming more expensive and may even require several procedures to get the final result.  Nevertheless there are a number of people who are candidates and would benefit from this procedure which would basically be permanent as opposed implants which have a limited longevity.  I have used fat grafting in Sacramento both for covering small defects and for breast augmentation at Advanced Concepts in Plastic Surgery with wonderful results.

#3. Vaser Hi Def liposuction.  I’ve been doing liposuction in Sacramento for over 20 years, Vaser liposuction for five and Vaser Hi Def liposuction for 1 ½ years.  There is a very confusing array of new technology, six different laser light machines a brand-new water jets Liposuction system and most recently radiofrequency.  However after reading the information and same salinity systems in action as well as speaking to my colleagues in the field of plastic surgery I’ve come several conclusions.

First of all, for multiple area liposuction skin shrinkage and maintaining viability of fat cells transferred Vaser Hi Def liposuction is the most advanced solution.

Second, laser liposuction works for small areas but is too time-consuming for larger areas.  It’s still unclear which wavelengths of light works the best despite all the claims.  There appears to be a lot at heat damage from the laser.  This does not allow viable cells for transfer.

Third, waterjet liposuction seems promising but it’s still really too new to say much about.

#4.  Thermage has had major technological advancements that have changed the game.  The new Thermage is not the same as the old Thermage.  Thermage has been around for years.  It is now in its third generation.  The first generation was effective but quite painful and needed considerable sedation.  Second generation was uncomfortable but manageable with a little sedation.  The new generation is not painful due to vibration of the tip which confuses the nerves in the skin and also has a cooling apparatus.  I’ve had this tested on myself and it is comfortable.  It is an ideal skin tightening: noninvasive, no downtime, procedure.  With the new changes it is now very patient and doctor friendly.  I recommend Thermage in Sacramento at Advanced Concepts in Plastic Surgery for my patients who need a little skin tightening but are not requiring the more dramatic results that can be a result of a tummy tuck, a face lift, arm lift or thigh lift.

#5. The Mini Lift, they’re back with a vengeance.  To paraphrase Shakespeare, ‘a rose as a rose is a rose.’  Mini face lifts have been around forever.  Actually, it can be argued that the mini face lift have been around since the beginning of the last century.  When I was at UCLA as a medical student, the chief made a lot of Hollywood happy by doing mini lifts every few years because they were small surgeries with minimal downtime.  Now there is a   huge move: for mini lifts, cheek lift, S lift or any other letter.  There have been some changes recently such as using deep purse string sutures that considerably improved the result.  Do they work?  For the most part they do.  However if all you have is a hammer everything in the world is a nail.  In other words, one must be prudent in determining whether a mini lift will work based on advice from a knowledgeable plastic surgeon who can offer other solutions if a mini lift will not achieve the desired results such as a regular face lift. Do I perform mini lifts on my patients in Sacramento?  Yes, I have been performing mini face lifts in Sacramento for about the last 25 years.  Now there are some newer features to a mini lift such as vertical vectors, barbed deep sutures and Vaser liposuction   Would they work for everyone?  No, that’s where the judgment comes in.

#6.  Acellular Dermis.  Acellular dermis is a manufactured product, most commonly made of porcine skin which has been treated to remove any chance of reacting with the immune system  This is then placed underneath the skin in breast augmentation revisions for cases of wrinkling or rippling.  It is also used for breast reconstruction to prevent those same problems.  Patients with thin-skin and implant problems have always been difficult because there was so little to work with.  With the acellular dermis there is now a solution that can solve these problems.  It also seems to prevent capsular contracture recurrence after breast augmentation surgery.  The times I have used acellular dermis on my plastic surgery patients in Sacramento in the last year I have been quite pleased with the results.

So there it is.  Some new ideas, some old ideas, and some ideas that have simply come back with a new angle.  It was a very interesting year with the common denominator being progress for plastic surgery patients, better plastic surgery results and safer and easier surgeries.

Yes, winter is the best time for plastic surgery because bundling up is comfy, covering up is warm and watching TV for a few days while it rains outside means you are missing nothing while letting your new breasts, abs, tummy, or all of the above heal up and achieve their ideal form in time for the spring unveiling!  And by summer, every bathing suit on the rack will be calling out your name!

This is your chance to schedule an appointment that will make next spring and summer two seasons to remember!  We have limited openings that we can still schedule during the winter surgery season and if you call today.

The timing could not be better for a tummy tuck, breast augmentation, breast lift, mommy makeover, or a newly sculpted 6-pack abs created by Vaser Hi Def liposuction!

Call Teresa at 916-925-5522 to schedule an appointment to discuss just how good you will be looking by next spring!