1. How do I know if I am a good candidate for a torsoplasty?The best candidates for torsoplasty have a BMI (Body Mass Index) below 30. BMI is a ratio of height to weight. Very muscular men may have a slightly higher BMI due to the very dense weight of their bones and muscles. To find your BMI, go to http://www.halls.md/body-mass-index/bmi.htm, enter your height and weight and click calculate.In general, the best candidates for a torsoplasty have a BMI below 30, are between the ages of 18 to 35-45 (or so), are in excellent health, non-smokers, have limited sun damage to their skin and have never been considered overweight. If you are or have been overweight, your skin has been stretched out, you have lost some elasticity and your skin may not tighten sufficiently after the underlying fat has been removed. This would result in unacceptable wrinkling and lax skin, treatable only with an additional skin tightening procedure (such as a tummy tuck).
2. Can a torsoplasty be done in a hospital?Yes. This can be your choice but in general, the costs will be more expensive. If it is done in a hospital, general anesthesia will be administered by one of the staff anesthesiologists. You can be discharged later on the day of surgery or you may elect to stay overnight. Dr. Jacobs may also recommend this alternative if he feels it is medically indicated and safer for you.
3. Are there any guarantees on the results of a torsoplasty? No. The results of any surgical procedure cannot be guaranteed – there are just too many variables and uncontrollable factors, including the patient’s own health and healing abilities as well as whether they actually follow the doctor’s instructions. The only guarantee provided to every patient is that Dr. Jacobs will spare no effort, time or expense to deliver the very best possible care.
4. Can a torsoplasty give me “six-pack abs?”No. The torsoplasty cannot provide muscle for you – only you can do this with extensive exercise. The surgery is designed to thin out the fat layer above the muscle layer and thereby reveal what is already there. In addition, Dr. Jacobs will routinely perform some “etching” to simulate the upper abdominal midline depression frequently seen in athletes. However, there are limits as to how much you can thin the fat layer before safety is compromised. A torsoplasty cannot, obviously, add muscle nor will it remove any muscle.The true bulging “six-pack abs” seen on very muscular men is rare in “average guys.” Bodybuilders with “six packs” train extensively have an extremely low body fat percentage and in many cases have taken illegal body-building drugs.
5. I am not satisfied with prior gynecomastia / abdominal liposuction surgery. Is there any help possible?Perhaps – it depends on what was done and how much tissue is left. Every operation produces scar tissue, which cannot be removed by additional surgery (it would only produce more scar tissue). It also depends on whether too much or too little tissue was removed – this can only be determined by a physical examination. Overall, this type of revision or secondary surgery is more difficult to do and the results are less predictable than initial surgery. Oftentimes, goals for secondary surgery have to be reduced and must be realistic — improvement is often possible – perfection is not possible. And in some cases, unfortunately, there is no surgical remedy possible at all. That is why doing your homework and choosing the right surgeon to perform your initial surgery properly is so very important!
6. Can you just treat large love handles and not the abdomen?Yes, if your abdomen is satisfactory but you have very large love handles, these can be treated separately
7. Is a torsoplasty covered by insurance?No – it is considered cosmetic surgery and is not covered by any insurance. In very rare circumstances, the gynecomastia portion of the procedure may be covered, in part, by insurance.
8. Is liposuction safe?Absolutely! It is one of the safest operations, hands down! Remember, liposuction is performed just under the skin – it does not invade any body cavity. However, it is still surgery and must be performed under the care of an expert, skilled and experienced surgeon.
9. What is the difference between liposuction, lipoplasty, and liposculpture?Nothing! These are all terms that have been used to describe the same process. Some doctors use smaller, finer cannulas in certain areas and then call it liposculpture, but it is basically all the same.
10. Would liposuction work if my skin is loose and flabby?Yes and no! Certainly, liposuction can work to remove the excess fat. However, the fat that was supporting your flabby skin is now gone and the result will be even greater flabbiness. Therefore, additional surgery, at the same time or at a second operation, will be needed to tighten the lax skin. This can take the form of a tummy tuck. These are much more extensive operations.
11. Can liposuction treat a very large abdomen?Liposuction can successfully be used to remove fat under the skin anywhere on the body, including the abdomen. In essence, if you can “pinch it”– it can be suctioned. However, there are instances where fat is located deeper in the body, within the abdominal cavity, for example. This type of “beer belly” cannot be treated by liposuction (except for the small amount of outside fat that can be pinched) or by any other surgical means. The only known treatment is extensive weight loss.
12. Are the results of liposuction permanent?Yes! Normal fluctuations in weight always result in individual fat cells either enlarging or reducing in size. But they are always there in the same numbers! Liposuction physically removes the excess number of fat cells from the body and they do not multiply and rebuild after surgery. However, if you over-eat and gain weight after liposuction surgery, each of the remaining fat cells will enlarge and you will then gain weight and bulk symmetrically over your entire body. The bulges, though, will never return. On the other hand, should you lose weight after liposuction surgery, then you will lose bulk symmetrically around your entire body and the results of the surgery will be even better!
13. What can be done with the fat that is removed?The fat is usually discarded as medical refuse. However, some new studies have shown that fat is rich in stem cells and some new companies are working to concentrate the stem cells and preserve them for individual patients.In some patients, the suctioned fat can be replaced as a “fat graft” in areas of the body that are deficient. Small amounts of harvested fat can be used on the face to fill in lines and hollows or to augment a cheekbone. Or, for example, there can be a depression in the buttock cheek which can be filled in with fat harvested from other parts of the body to make it smooth and round. Sometimes the entire buttock can be enlarged with fat grafts, the so-called “Brazilian butt lift.”
14. Is there a limit as to how much liposuction can be done at one time?Emphatically yes! Liposuction is real surgery and always results in some amount of fluid and blood loss. A properly trained plastic surgeon will always use his be
15. Must I lose weight prior to torsoplasty surgery?Not necessarily! If you are at or close to your normal weight, then you are just fine. If you wish to lose just a few pounds before surgery, that is also fine. If you are grossly overweight, you may not be a candidate for a torsoplasty at all.
16. What should I do in preparation for torsoplasty surgery?Eat a proper and healthy diet – no fads at this time. Stop smoking for a minimum of two weeks prior to and two weeks subsequent to surgery. Stop aspirin and other products (a list will be provided) at least two weeks prior to surgery. You may continue exercise training up to the day prior to surgery. Follow the doctor’s instructions about individual medications you may be taking.
17. What should I do after torsoplasty surgery?After surgery, drink plenty of fluids for the first 24 – 48 hours. Eat a healthy, balanced diet with lots of protein, which you will need in order to heal. Some additional Vitamin C and Zinc supplements are helpful. Arnica pellets (available at the doctor’s office) and arnica gel can help reduce swelling and bruising.
18. Can liposuction treat a fatty tumor?Yes, it is very successful in treating fatty tumors, commonly called lipomas. The only problem is that liposuction will destroy the tissue in the process of removing it, so an absolute diagnosis cannot be assured. Also, these fatty tumors can sometimes recur after liposuction. The alternative is surgical removal of the lipoma, which will leave a linear scar and also a possible contour deformity.
19. What is meant by ultrasonic liposuction (UAL), PAL, Vaser, and SmartLipo?These are all different methods of removing fat. Ultrasonic liposuction (UAL) was introduced with great fanfare, claiming to make standard liposuction better and easier. It utilized an ultrasonic probe which turned the fat into liquid and then standard liposuction had to be used to remove the liquid. Unfortunately, in some cases, the ultrasound probe produced burns and extensive post-operative pain. It has lost following but in the hands of an experienced surgeon, it can still be useful.PAL is short for Power Assisted Liposuction. In essence, it is a cannula attached to a motor which creates very short back and forth strokes. Although originally touted as a finesse tool, it is now used simply to make the work of liposuction less strenuous for the surgeon. It is useful but not essential and does not offer any benefits as regards the final results of surgery.Vaser is a pulsed ultrasonic liposuction machine. It has reduced some of the problems of the original ultrasonic liposuction and is touted to help the skin to tighten — it is still being used. It is not substantially better than traditional liposuction.SmartLipo (and others) are the latest additions on the liposuction scene. It offers a laser which travels under the skin to destroy fat cells. The body then scavenges and removes the dead fat cells and released fat. Some surgeons use the laser and then traditional liposuction to remove the released fat. Its main claim is that it tightens the skin at the same time. However, this has not as yet been scientifically proven. There have been some reports of skin being burned by the laser. SmartLipo has yet to prove itself amongst many plastic surgeons but it is being heavily hyped to the general public.
20. What is on the horizon for body contouring?Non-invasive is the key word here. Studies are proceeding to use focused external ultrasound to kill fat cells – but it is ineffective on breast tissue. The damaged fat cells are then scavenged and removed by natural bodily processes. The machines do have limitations but stay tuned – this is exciting!