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Liposuction and Body Contouring

Paul Charles ZWIEBEL MD
Colorado, Littleton
Plastic Surgery
Registered Site MemberHas 2 suggestionsAddress AvailablePhone Numbers AvailableHas 10 ArticlesHas special expertise in certain sicknessHas TagsPersonal Info AvailableHas Personal Website
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* Date : 05-05-2008 - 08:01 PM (5806 days ago),

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Testimonials For Paul Charles ZWIEBEL MD by our Site Visitors:
Dr. Zwiebel and his staff were extremely friendly, helpful and professional during my breast augmentation consult, pre-op, surgery & post-op. Dr. Zwiebel took his time speaking with me during the consult and was just as relaxed and friendly at the 6 wk post-op appointment. He did a FANTASTIC job and I have zero complaints!! His staff are extremely pleasant to deal with and deserve kudos as well. Way to go team!!
(Michelle, Patient, 11-21-2008)

I cannot say enough about Dr. Zwiebel and his entire staff! I chose to have breast augmentation surgery a year ago and I kept putting it off and I now think it was because I hadn't found the right doctor. In February of 2008, Dr. Zwiebel was recommended by a former breast augmentation patient of his. I decided to meet with him and I am so glad I did. After our initial consultation, I knew that I had finally found my doctor. Many of my friends have asked "how did you know he was the right one?" My best answer is that he made me feel safe and that I would be taken care. He was so attentiv... [More..]
(Kim, Patient, 04-28-2008)

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Liposuction and Body Contouring

Liposuction (Lipoplasty, Suction Lipoplasty, Fat Suctioning, Fat Removal, Suction Assisted Lipoplasty, Lipolysis, Suction Lipolysis, Body Contouring, Fat Contouring)
Everyone knows that the healthiest way to maintain your weight is through diet and exercise. But when stubborn fat pockets do not respond to diet and exercise, or to correct disproportionate fat deposits and body contours you may want to consider liposuction.
Having over 25 years experience in body contouring procedures and hundreds of hours of continuing education to keep abreast of the newest techniques, Dr. Zwiebel offers the experience and knowledge to advise you if you are a reasonable candidate, if your goals can be realistically achieved, and which of the techniques is best suited and safest for your specific goals.

Liposuction Simplified and Debunked
The media is full of articles and advertisements about liposuction techniques that are “better and safer.” Brand names and trademark types of Liposuction or Lipolysis offer promises of being better than other types of Liposuction or Lipolysis. Without the help of an experienced doctor, it can be impossible to differentiate between marketing hype and what is really best for you.
As you consider liposuction, it is important to realize that no matter the technology, the most important factor in getting optimal results remains the experience and skill of the surgeon! Even the newest and most sophisticated technologies do not compensate for skill and judgment.
Making sense of it all: In all these techniques of fat removal or fat contouring there are two elements.
• Lipolysis is the dissolution or liquefying of the fat. This can be accomplished many ways and this is the major difference among the different technologies and “brands” of liposuction.
• Lipoaspiration is the Fat Removal part of the liposuction procedure. This is done using a suction apparatus: sterile tubing and a suction machine that creates sufficient vacuum to remove the liquefied fat.



Tumescent Liposuction (Tumescent Technique, Tumescent Lipoplasty, Traditional Liposuction / Lipoplasty, Conventional Liposuction / Lipoplasty)
For over 20 years, surgeons have been using the techniques of liposuction with ever increasing safety and predictability. The term “tumescent” refers to using a relatively large volume of very dilute anesthetic (numbing) solution to fill the tissue spaces. The benefits include keeping the amount of medication within very safe limits and dramatically diminishing bleeding and bruising.
Tumescent technique is commonly combined with other liposuction techniques, including those discussed here.
The Traditional Liposuction or Conventional Liposuction uses the mechanical force of the cannula (hollow tube) and the suction to break up the fat globules simultaneous to the removal with the suctioning.

Power Assisted Liposuction / Lipoplasty (PAL) is a significant improvement over Traditional Liposuction or Conventional Liposuction. The instrument does not depend on the force of the surgeon to disrupt the fat cells.
• Lipolysis is accomplished through the rapid back and forth (reciprocating) motion of the instrument.
• Fat Removal is simultaneous with the suction tubing and machine.
The design of the PAL device creates short gentle strokes that gently disrupt the fat cells with very good selectivity for the fat cells. The result is more rapid removal of fat, so surgery and anesthesia time is reduced. There is also less bleeding, and bruising, so recovery involves less pain and quicker return to normal non-strenuous activities.
There are no real disadvantages to this technique, but it is probably most advantageous for removal of relatively large fat deposits.
Ultrasonic Assisted Liposuction (UAL, Ultrasound, Ultrasonic Liposuction, VASER®,, VAL, VASER®, Assisted Liposuction, VASER®, Lipoplasty, )
Ultrasonic assisted liposuction has been refined and improved over many years.making it the technique preferred by many surgeons who routinely perform liposuction and body contouring procdedures. .
• Lipolysis (the liquefying of the fat) in this type of liposuction uses ultrasonic energy to selectively liquefy the fat cells.
• Fat Removal is accomplished with suction tubing after the dissolving of the fat cells by the ultrasound.

Ultrasound is an extremely fast vibration (10,000 times/second or more). This rapid vibration dissolves the fat cell, allowing for easy removal with suctioning. Not every ultrasound device is effective for liposuction; the frequency of vibrations should be tuned to be most selective, targeting fat cells for dissolution, while causing minimal injury to surrounding blood vessels, nerves and the tissue connections to the skin. The VASER is probably the best example of this approach of Lipolysis because the fine probes used to deliver the ultrasound are very small (requiring very small incisions, usually less than ¼-inch in length); the tuning of the energy for maximal selectivity appears optimal to be highly selective for fat, leaving less trauma to the little blood vessels and nerves that run between the fat cells.
Reduced trauma means less blood loss, swelling and bruising after the liposuction procedure. This usually means a lot less discomfort, as well, making it easier to get moving and back to most normal daily activities more quickly (faster recovery).

A disadvantage of this technique is that more surgery time is necessary for the application of the ultrasonic energy. The ultrasound energy also generates heat, so there is a small risk of a skin burn, though this rarely occurs with precautions routine to this technique.
In general, the advantages of Ultrasonic Liposuction using the VASER technology far outweigh the disadvantages.



Laser Liposuction (SmartLipo ®)

Lasers are now being used to dissolve the fat as part of a Liposuction procedure.
• Lipolysis (the liquefying of the fat) in this type of liposuction uses a laser to non-selectively liquefy the fat cells.
• Fat Removal is accomplished with suction tubing after the dissolving of the fat cells by the laser.
This appears to be a situation here the appeal of high tech seems more important than science or good clinical studies. The lasers used in this technology are not in any way specific or selective for fat. In fact, the manufacturer is changing the laser settings in the next generation of these machines. The appeal here appears to be primarily to try to oversimplify what remains a surgical procedure and give the impression of greater safety, reliability and less “invasiveness.” Yet, none of this is substantiated with basic science or sound clinical studies.
I perceive this to be a marketing tool, rather than a better way to do lipoplasty.


Injection Lipolysis (Lipodissolve®, Mesotherapy)

A new technique has been evolving using injection of a chemical (phosphatidyl choline) that can be used to selectively dissolve fat. For years, claims were made that this could be accomplished using a technique commonly called Mesotherapy, but there was an unacceptable level of consistency in the way the procedure was performed and a lack of adequate scientific and clinical research to support the claims.
• Lipolysis is accomplished by injecting a chemical that primarily dissolves fat.
• Fat Removal is slowly done by the body’s own healing, removing the chemically dissolved fat.

It appears that Dr. Diane Duncan has done the most careful laboratory and clinical research resulting in a successful formulation for Injection Lipolysis that produces the most reliable results when carefully following her protocols. Interestingly enough, some of the advertisers for Injection Lipolysis (also called Lipodissolve®, or Mesotherapy) cite her research even though they use different chemical formulas and techniques.
The chemical formulation is not approved by the FDA. Before undergoing Injection Lipolysis, a patient must sign a document explaining that this chemical treatment has not yet been through the FDA approval process. Some practitioners have tried other drugs (like Lipostabil, from Europe) approved by the FDA for other purposes (so called “off-label use), but these drugs have been shown to produce poor or inconsistent results.

Injection Lipolysis is still being researched to determine best techniques, ideal candidate selection and recovery. The best candidates are those looking for relatively small volume reductions.

Many consider the procedure minimally invasive, because it is non-surgical and performed without sedation or anesthesia. Recovery does entail soreness in the area of Lipolysis as the area heals: this often takes weeks.

Disadvantages of Injection Lipolysis (Lipodissolve®, Mesotherapy) include the relative newness of the technique and shorter time course of studies showing optimal treatment regimens and results. Almost no one can show you before-and-after photographs of their own results at a year or longer.

What is most important in achieving a good result in lipoplasty? No matter the technology, the single most important factor is the surgeon. Technology is not a substitute nor does it compensate for judgment, skill and experience.

Liposuction procedures are typically performed local anesthesia with or without IV sedation, depending on the amount of liposuction and the technique to be performed, and the preferences of the patient in consultation with the surgeon. In our practice, Dr.Zwiebel performs these procedures in our fully accredited surgical suite and patients will return home wearing a compression garment, a body girdle, that will aid healing and smooth contours. Typically, the patient will wear the garment for about six weeks. Most patients resume their daily activities after the first week of recovery, but it is important to avoid strenuous activities for the first six weeks of recovery. Initial discomfort is easily controlled by oral medications.
Of course, Liposuction is a surgical procedure and, as such, carries with it some risk. We encourage all patients to learn as much about the process before undergoing Liposuction. We encourage all patients to learn as much about Liposuction (Body Contouring, Injection Lipolysis [Lipodissolve®, Mesotherapy), Ultrasonic Liposuction [UAL], VASER®,, Tumescent Liposuction, and Power Assisted Liposuction [PAL]) and recovery before undergoing a procedure.
We look forward to helping you learn more during a personalized consultation to learn if you are a good candidatefor Liposuction, and which technique would be best for you and your specific goals.. Our patients should gather as much information as possible and also direct questions to our friendly staff. As in all surgical procedures, safety is the highest priority.

Common procedures performed with Liposuction include: Breast Enhancement, Breast Support, and Abdominoplasty.
To learn more about Ultrasonic Assisted Liposuction, please contact our office today!
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Abdominoplasty
Abdominoplasty, also known as a tummy tuck, is a procedure designed to tighten the muscle of the abdomen, remove fat above the muscle and under the skin, and tighten and smooth excess skin of the abdomen. If you have loose or sagging abdominal wall skin (often a result of multiple pregnancies or prior treatment), excess skin, or a stubborn bulge you can’t get rid of with exercise, you may be a candidate for abdominoplasty. The procedure is intended to give the patient a smoother, flatter abdomen.
As abdominoplasty deals with three areas: the muscle of the abdomen, the fat of the abdomen, and excess skin of the abdomen. Each patient will have a varying degree of need for each area, and the tummy tuck procedure itself is modified per patient. The incision size required will fluctuate according to the patient’s situation, but usually extends across the lower abdomen above the pubic bone. The incision allows us to tighten the underlying muscles, remove fat, and excise excess skin. This creates a smooth, flat abdomen. For women considering future pregnancies, we suggest postponing an abdominoplasty procedure since pregnancy may diminish results.
Unlike most practices, our practice provides abdominoplasty patients with anesthesia pumps. An anesthesia pump is a small device with a thin catheter that connects to the central nerve bundle in the abdomen. It drips local anesthetic into the treatment area for three to four days and numbs the area enough for patients to significantly reduce their dependence on narcotics (which can have side effects). Our patients are much more comfortable with this device and experience easier recovery.
We would like to emphasize that abdominoplasty is a surgical procedure and, as such, carries with it some risk. We encourage all patients to learn as much about the process before undergoing an abdominoplasty. Our patients should gather as much information as possible and also direct questions to our friendly staff.
Common procedures performed with Abdominoplasty include: Breast Enhancement and Liposuction.
If you live in or around our office, abdominoplasty information is available at our office. Please contact our practice today.
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Thigh and Buttock Support
For our patients experiencing sagging and excess skin of the thighs and buttocks, we offer body support procedures designed to improve the shape and tone of the lower body. Body supports, such as thigh and buttock support, are not solely intended to treat excess fat. If the area has retained good skin elasticity, liposuction alone can remove fat deposits and improve body contour. However, if the area suffers from excess skin or poor elasticity, a combination of liposuction and body lifting will be required. Individuals who have lost massive amounts of weight often experience excess skin and may be candidates for the procedure.
Body lifting procedures may be appropriate for patients who are of stable weight that is reasonably proportionate with their height. There is no other method of body contouring that can restore body shape and skin appearance as well as body support procedures. However, as with any other surgical procedure, body lifts require incisions; in some cases incisions may be extensive. Incision length and pattern depend on the amount and location of excess skin to be removed. In many cases, the doctor can place incisions in strategic locations where they can be hidden by most types of clothing and swimwear.
We would like to emphasize that body lifts are surgical procedures and, as such, carry some risk. The doctor encourages all patients to learn as much about the process before undergoing a body treatment. Our patients should gather as much information as possible and also direct questions to our friendly staff.
Common procedures performed with Body Lifts include: Breast Enhancement, Breast Treatment, Breast Reduction, and Liposuction.
For more information about the Thigh or Buttock Treatment, please contact our office today!
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Arm Support
Significant weight loss and natural aging can cause a patient’s arm skin to become loose and flabby. This excess skin can be the cause of embarrassment and limit clothing choices. Arm lifts remove the excess skin and fat to reveal thinner, tighter-looking arms.
During the arm treatment, the surgeon will make incisions on the underside of the forearm. Excess fat will be removed through liposuction and underlying muscles will be strengthened and held in place. Next, any excess skin will be trimmed away and lightened. The incisions will be closed with small sutures. Initial discomfort is easily controlled by oral medication most patients return to light normal activity after several days.
We would like to emphasize that arm treatment is a surgical procedure and, as such, carries with it some risk. The doctor encourages all patients to learn as much about the process before undergoing an arm treatment. Our patients should gather as much information as possible and also direct questions to our friendly staff.
Common procedures performed with an Arm Treatment include: Breast Enhancement, Breast Treatment, Breast Reduction, and Liposuction.
Please contact our office today to find out more about arm treatments and other body contouring procedures.

Visit our plastic / cosmetic surgery office located in Littleton, Colorado (CO), conveniently near the Denver, Colorado area.

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