An Examination of the Smart Lipo Procedure
Laser Lipo to Smooth the Fat
An examination of the Smart Lipo procedure, taking you through all the steps from the beginning to the middle to the end. This procedure is liposuction done in office under local anesthesia. We’re also going to use the Smart Lipo laser to help us smooth the fat and tighten the skin. We’re going to show you from the beginning from taking pictures to her anesthesia to the end to the aspiration of the fat to the laser procedure.
Tighten the Skin
The patient will be awake during the procedure she’ll have some light sedation but you’ll see due to the anesthesia that you will not be feeling anything the great thing is you will not have the risk of general anesthesia nor the recovery in fact at the end of the procedure she’ll get dressed up and go home numb so let’s begin the procedure now have you lift your arms up there you go let me just do a picture from the front and from 45 degrees right there get and from the side here hold Keener kind of separate the abdomen into some couple of segments this is a lower abdomen and these markings actually are topographical they tell us where the most fat is so that’s what we can go after I’m going to look up here at your rib cage it’ll be our upper limit of our procedure look here and here then we have some upper abdomen fat we’re going to mark that or the most fat is going to look over here at your love handles going to be turnover you see where fat is on the love handle when you come up here look at the other look okay if we’re going to start the preparation for the tumescent anesthesia so the tumescent anesthesia is the most important part of this procedure that’s where we add the saline solution that contains the lidocaine and epinephrine that makes this whole procedure possible so what we’re doing first is a skin prep with some betadine that’s just to prepare the skin for now bacteria so we’ll just do a thorough prep you give you a little stick here now just down a little area of local anesthetic and I’m going to use a little punch to make a little hole little incision doing okay good so they’ve already made a little incision so the next step is going to use a catheter to instill the local anesthetic and selling parts a little uncomfortable but we are putting on aesthetic in so it goes numb very quickly okay you can see it’s just fluid that comes out of this catheter it’s harmless aliens and whitey came and we’re doing is we’re putting this into the fat layer between the skin and the muscle this is what area we work in that fat layer so we’re filling it up so it’s doing a couple of things you can see it’s expanding so it’s lifting the fat up off the muscle it’s giving a space to work and it’s filling it with lidocaine lidocaine’s blocking her nerves so she won’t have any pain and the epinephrine in that solution also constricts the blood vessels so there’s no bleeding two and a half liters of fluid so far you can see how her abdomen is now swollen with the fluid you can even see it’s blanched what that means is it’s you know kind of whitish and that’s because the epinephrine is working constricting the blood vessel so there won’t be any bleeding and you can see we just made a few small incisions very tiny and one by her abdomen I one by her belly button she’s done very well she’s been a great patient almost finished here you also even see the orange peel appearance which indicates we have really good two masters so what we’re going to start now is the period where she’s just gonna hang out and do whatever she wants and I’m gonna let this tumescent fluid just percolate in here and by the time we start she will be completely no okay we’re gonna start the procedure she’s now to mass she’s been waiting for about a half hour she clears her skin condition looks good she’s well Blanche we’ve prepped her thoroughly do you have any sensation there I feel numb she feels numb you will feel some movement during this procedure but the pain fibers of wall okay now if we get to an area where you feel that there is pain let us now we have a reserve of anaesthetic foot so the first thing we do is we do is called tunneling we use a special cannula that makes tunnels in the fat we do this because we want to make room for our work so just going to work in different areas and cannulate with this is called a rasp ER and it actually will liquefy some of the fat and make tunnels you can see it moves in very easy because we have that fluid in there aspirate some fat use a different cannula for that this county only has little holes on the bottom so it actually the top protects the under surface of the skin we just want to take the fat underneath so we’re going to start some lipo here main goal in the beginning here is just to make this fat layer smaller lobules a flat sat with that tumescent solution we put in so it’s basically a blind procedure working through small little holes and we see nice fat no blood coming out but the way I tell it is what’s going on is my hand I’m working underneath my other hand and I can feel the layer of fat getting smaller and then I also look at the tubing to see what we’re getting out so it’s a lot of it is just by feel and by looking at what’s the return is so I could feel her fat layer getting small and how are you feeling any pain you feel some movement okay see she’s very comfortable left lower quadrant for the abdomen right now when we try to do is work each quadrant so we know how much fat we get out of these quadrant you want to try to get symmetry so I keep track of that so we get even amounts of that out now if you like we’ve already done some of this floral quadrant you look in the jar we have about 400 CCS a fan out from there you could already see a visible difference from the right to the left so now we’re going to start some aspiration of the of her rights same thing you’d see the fat coming out nice chunk of fat no big bleeding so we want to say we just want to see flat fat and the mess included in return so basically we just go through each quadrant and we increase the layer of fat a few millimeters at a time is we’re really trying to do here is not just take out a large amount of fat this is a sculpting procedure wanna leave a smooth uniform fat layer so it sold out Dan even it’s not about the amount of fat we take to see amount of fat we leave because when she goes home she’s going to be looking at the side I left on her body not the fat I’d tusks so that’s the most important part patients come in they walk a lot one to know how much fat they want the most amount of fat taken but the true concept is to leave the right amount of fat and leave it in the right condition so that she looks good as a result she won so we’ve been aspirating we’ve already removed one full container you could see mostly fat this is the some of the fluid at the bottom it’s a little blood tinge but it’s all normal but a good amount of fat there we will almost filled up another container she’s been pretty comfortable she’s had a few pokes here and there but otherwise pretty comfortable you could see her results already could see from where we started for abdomen is almost flat we could see her ribcage and her waist is starting to get tighter probably gonna take off a little more fat but at this time we’re going to go to start doing some of the SmartLipo laser this is the laser cannula and fiber the fiber comes out through the end here we go through the same incisions and basically what we’re trying to do here is two things depending on the light the level you can see the light here under the skin that helps me see where the laser is we’re doing two things one the laser hits the fat cells and causes the fat cells to melt liquefy helps us get more fat out it helps us make that smooth layer nice that fat layer nice and smooth remember before I said that’s the whole key to this is for us to leave a smaller smoother fat layer the other thing we do is we heat it we’re heating up right under her skin and the reason we do that is when you heat up under the skin causes skin contraction and new collagen formation so not only do we want to get a nice smooth fat layer but we want her skin to retract so it fits nicely over her muscles and the remaining fat layer and give her a nice result so so basically just like the aspiration we just eat with the laser in these quadrants and basically what we’ll see is you’ll actually get a return of a greasy fluid that’s the melted fat but it’s an important part of the procedure because we want that fat layer rocket said smooth and we want to get that skin retraction and some people do the laser first we will do that sometimes first before the aspiration it’s a very thin patient because we will get some fat melting with it but my opinion the laser should be done after the aspiration because we want the laser to be kind of our fine-tuning of the procedure it’s going to smooth out that fat layer and we want the heat to also be used for skin tightening see she’s much flatter she had a you know a good amount of fat around her lower abdomen you can see it’s almost flat at this point and to remember she does have to mess and food still in here so this will drain over the next couple of days from these incisions we want her to drain because the drainage helps her actually recover quicker and there was melted fat in there that we don’t want her to absorb in fact if I touch it it’s greasy so by letting her drain she gets better faster and she doesn’t absorb any melted fat those incisions wilkes heal on their own in 48 hours and the drainage will stop we don’t have to suture them or anything they go fine and we’re going to put her in a compression garment it’s a tight undergarment she’s going to wear that for about three weeks three to four weeks after the procedure she’s not right now so get dressed go home she’ll get sore later on so we will she will have some pain medicine and then about a week she’ll have a massage because she will get and get a different type of swelling after the procedure that usually goes away in three three to four weeks – you can see the amount of fat and containers that so we got from her and the bottom part is tumescent fluid so we got a good about two liters of fat off her abdomen just the right amount of fat you can see her ribcage is showing she’s flat he’s got more of a waist and we’ll see how this all heals up and the experience was it bad yeah and for the most part she was now I’m she had a couple of points where we got towards the edge where she got a couple little surprises but you know she has no recovery now and you know she’s just going to go home.