liposuction pros and cons

thank you for your question.you submitted a single photo and you are stating in your question that you underwent a laserlipo of the neck approximately a year ago and you feel that your neck actually looksworse than it did before and so you are asking about potential options to help the neck lookbetter. well, i can certainly share with you my approachto evaluating people like yourself who have come into my practice with exactly the sameissue. i can give you a little bit of background. i’m a board-certified cosmetic surgeon andfellowship-trained oculofacial plastic and reconstructive surgeon. i’ve been in practicein manhattan and long island for over 20 years. i specialize in facial aging rejuvenationprocedures including liposuction, laser-assisted

face and neck lifting and i’m very muchfamiliar with this type of scenario. so, i begin first by helping you understandhow i assess patients who have concerns about this area which of course, you can imagine,it is a very popular area where a lot of people want to do something about. so to begin with,first is determining if there is excess fat. second is if there is excess skin. third,is there any laxity of the underlying muscle which is called the platysma muscle and alsoare there any bands related to the platysma muscle and then also what does the neck looklike in the context of the rest of the face. is there also any facial descent? now, there are different scenarios which peoplelike you end up in this place and i’m seeing

it a little bit more often and not just becauseof laser-assisted lipo but now there are other options in the market to help also try toavoid certain surgical procedures. and so a lot of people are trying to treat fat asthe enemy or try to tighten the skin without treating anything else. so, you are certainlyin good company of people who are frustrated with the results of procedures that didn’tturn out the way they expected. here is one of the major issues that i’veseen from a long time, for many years and that is the perception that fat under theskin is a bad thing. and particularly, when people come who have extra skin and ask me,“can you just lipo this area?” because everyone thinks that they have too much fat.so proper diagnosis is the take home message

that even if there is a little bit of extrafat, how much will the procedure make a difference? because the point of the laser versus lipoalone was that the hope was laser would melt some of the fat and would make it a littlebit easier to remove. but really, technically speaking, taking fat from under the chin isnot that difficult but the major benefit is the retraction of the skin meaning that ifyou have some loosening of the skin, maybe it will retract upward. here is the problem: you can’t always reallyaccurately predict how much someone will retract. you know that if you do those laser procedures,you would get more retraction than otherwise but would that be significant enough? andi think that even though i know that a lot

of people believe strongly in this technology,it is always about patient selection and who really can benefit from that. the situation like yours is also and not specificallyto you but it could have been the scenario where someone recommends that you undergoface lifting or face and neck lifting or just neck lifting alone and that situation, peoplewill often kind of brace, “well, i’m not ready for that yet.” and the well-meaningdoctor then says, “we will do something like laser lipo.” well, that being said, at this point, it isclear that you are dealing with some skin laxity and so a proper evaluation on how tomanage that skin laxity will guide you as

to what the next step is. typically, it isgoing to be some variation of other facelifts, face and neck lift and even a limited necklift. now of course, all these procedures have their pros and cons and i think thatyou really have to get a more comprehensive evaluation. i don’t think that non-surgicalskin tightening whether it is radiofrequency or nd:yag laser will be adequate. with thosetechnologies, i think they have some benefit but really i think it is more a qualitativeimprovement and not a quantitative improvement. so, i think that understanding that clearlyfat is not the only problem that you’re dealing with but you are dealing with skinlaxity as well as skin quality and there are definitely many options. in our practice,when i do facelift, face and neck lift for

those patients who are really concerned aboutthe scenario of having these types of procedures, i basically reassure them that these typesof procedures are done under local anesthesia with liteâ„¢ sedation. so a lot of times,they are intimidated by the idea and fearful about the idea of going under general anesthesiaand that the procedure is done minimally traumatically. i use a lot of different techniques. i tryto expedite the healing process and deliver the best result as possible and you may benefitfrom some tissue regenerative technologies such as the use of platelet-rich plasma (prp)to stimulate collagen in the skin which can be used concurrently. there are more than a few ways to do thisand do it in a way that is comfortable and

safe. we do our procedures like this in ourfacilities, in our offices which are certified by the joint commission so it is basicallythe same people that certifies the hospitals, surgery centers where we are meeting thosevery stringent standards for safety and personnel and sterility, etc. so, i think that ultimately you need to meetwith qualified and experienced cosmetic surgeons who can guide you and you can figure out whatkind of outcome best suits you and how to achieve that in the safest and most predictableway. so i hope that was helpful, i wish you thebest of luck and thank you for your question.