Introducing VASER Liposuction
Are you exercising, dieting, and trying your best, but still having trouble with those last, stubborn ten pounds? There is an alternative, easier way to improve your body shape.
VASER-liposuction may be the solution you are looking for. This is not liposuction, it is a process where fat cells are selectively melted using an ultrasonic device that emits 36,000 pulses per second, bursting and vaporizing the fat cells. This is a new, cutting-edge approach to face and body contouring.
What Liposuction Techniques Separate Dr. BYUN From Other Plastic Surgeons?
Dr. BYUN is an expert with the VASER, as he was the first person to use it for liposuction purposes in the Midwest. He found that VASER led to less bleeding and helped tighten skin during the process, resulting in smoother contours. One of the biggest perks is that VASER leaves you with little to no scarring, due to the tiny incisions utilized by Dr. BYUN. This procedure can be done on other frequently scrutinized areas like the arms and neck, among others.
Expertise With The VASER Ultrasonic Liposuction Machine
While older generations of liposuction machines could cause excess bleeding during surgery and could leave the skin with a lumpy, sagging appearance following the procedure, the VASER differed from its outdated counterparts in one important way: ultrasonic technology. This device is fairly new, being introduced in 2000. Dr. BYUN taught other doctors how to use it and its positive effects when the model was released. The VASER utilized sound waves at very high frequency in order to burst and melt fat cells, leaving you with stunning results almost immediately, while avoiding the bleeding and damage older liposuction machines caused.
The tumescent solution is a mixture of lidocaine (anesthetic), lactated ringer, and epinephrine and is injected into the targeted area in order to induce swelling in the cells. This makes it easier to break down and remove the fat cells with the probes and also reduces bleeding. The suction probe that removes the fat also has a positive side effect of tightening the skin as it does its job.
Over the last ten years, plastic surgeons like Dr. BYUN have found incredible success in this device, especially because it was versatile and could be used not only on the lower body, but also the chin and cheek areas as well. Dr. BYUN chose this machine using his expertise in medical technology gained from experience as a leading teaching surgeon at Rush, UIC, and Northwestern Medical Schools.
Liposuction Patient Case
We have provided a sample copy of an Operative Report. The procedure is subject to change per the patients needs.
PREOPERATIVE DIAGNOSIS: Lipodystrophy of the abdomen and neck
POSTOPERATIVE DIAGNOSIS: Lipodystrophy of the abdomen and neck
OPERATION: Liposuction using Vaser neck and abdomen
After induction of general anesthesia in a supine position, she was prepped and draped in the usual sterile fashion. 700ml of tumescent fluid was applied to the abdomen where 10 minutes of Vaser using the ring probe at the set up of 80% were carried out. About 1:1, 700ml of fatty aspirates were taken out through the umbilicus incision. Then, the suprapubic area incisions were closed using 5-0 Prolene. Next, a stab incision at the submental area as well as the post aurlcular area was made. 200ml of tumescent fluid was injected and 4 minutes of Vaser time was utilized using a 2.9mm cannula at the setting of 70%. Using the 3 ring probe 200ml of fatty aspirates were taken out from the neck and chin region. The incision was closed using 5-0 Prolene. A bulky dressing was applied. A garment was applied to the body. The patient tolerated the procedure well, was extubated and was transferred to the Recovery Room in good standing.
You will be sent home following the surgery wearing a garment that compresses the surgical area. Underneath this garment will be gauze to control the bleeding and epi-foam to help the areas to maintain shape. Leave all this intact for 48 hours. There should be an opening on the garment to allow for bodily functions. After 48 hours: remove, wash, and air-dry the epi-foam and compression garment (if you have them). Remove and discard the gauze as well. Do not remove bandages covering incision areas, if any. Next, follow instructions for showering and incision care as previously started. Cleanse any uncovered incisions 3-4 times a day using a cotton ball or swab soaked in saline water (found at your local pharmacy). DO NOT USE HYDROGEN PEROXIDE OR ALCOHOL TO CLEANSE INCISIONS. Continue wearing the compression garment and epi-foam until your follow-up appointment with Dr. Byun. At that point he may ask you to change your garment to a stage 2 garment (which is a smaller size) after the first week. Our staff will assist you with obtaining this garment.
Fluid will leak out for the first 24-48 hours. Therefore, we suggest sleeping on an old sheet and the blue pad that you will take home from the surgery center. If you have liposuction on your thighs or legs, elevate your legs by placing a pillow under you knees as this will help reduce swelling in the lower legs.
Foam tape or yellow sponge tape may have been applied, too, after surgery. Please keep foam tape on for 5-6 days following your surgery. Starting at a week following your surgery, you can start removing this tape. When you shower, the tape will start to peel away. By the time you are coming in for your first post-op appointment, your tape should be completely removed. Please do so in order to avoid a painful tape-removing process.
There will be swelling after surgery. Even wearing compression garments, a significant amount of swelling will be apparent for several weeks. It will go down in time. Although activities that increase your blood pressure should be avoided, it is important that you walk. This greatly aids in reducing post-operative swelling. When you are sitting, elevate your feet as much as possible.
What Should I Expect After Liposuction Surgery?
After your procedure, you can expect bruising, swelling, and tenderness in the areas where liposuction was performed. You will wear a compression garment for six (6) weeks post-surgery. Bruising, Swelling, and Stitches (which can pucker) are all NORMAL. Tissue firmness is NORMAL. Your body may not heal symmetrically, meaning one side may take longer to heal than the other, this is NORMAL. Any previous asymmetry may remain.
How Long Does The Recovery Take? When Can I Go Back To Work & Exercise?
Depending on both the surgery and your own physiology (your body’s healing), most patients have a downtime of two (2) to three (3) weeks before returning to daily activities such as exercising. During the first ten (10) days, we ask that you do not do any activity that increases your heart rate. This is to help the healing process, since the blood clot that has stopped the bleeding from the surgery dissolves in about seven (7) days. After ten (10) days, increase activity by ten percent (10%) each week as tolerated. Stop activity if you see a dramatic increase in swelling when you wake up the following day. At the one (1) week post-op visit you will be provided with healing instructions and what specific activities are allowed. Patients can usually return to work after one (1) week.
Is There Pain Or Discomfort After Liposuction Surgery?
You will not feel anything during the procedure, since anesthesia will be used. However, after the anesthesia wears off, you will feel some pain and discomfort. It is highly recommended that you start off taking Extra Strength Tylenol, every six (6) to eight (8) hours, alternating with Motrin. Please DO NOT MIX pain relief medications together at the same time. If you are experiencing a higher level of pain, please take the prescribed pain medication (Norco, or other prescribed pain medication). During the two (2) days immediately after liposuction, the amount of pain experienced depends on the type of anesthesia used for liposuction. Soreness is usually the most intense two (2) to four (4) days after liposuction and then decreases steadily. The tenderness and soreness typically is quite bothersome for up to four (4) weeks, but gradually subsides over the following next four (4) to (8) weeks.
How Does Abdominal Liposuction Differ From A Tummy Tuck?
A Tummy Tuck (Abdominoplasty) is a major surgical procedure requiring general anesthesia, and involves making a large cut in order to remove excess fat and skin. Abdominal Liposuction is a more common procedure and can be done both under local and general anesthesia (your surgeon will choose which is right for you). Liposuction involves making various smaller incisions and removing fat using a long skinny surgical instrument.
Can Liposuction Be Performed In Conjunction With Other Procedures?
Yes, Liposuction is often a key part of a “Mommy Makeover” – a group of procedures that may also include:
- TUMMY TUCK – to remove excess fat and skin
- BREAST AUGMENTATION – to add volume to the breasts
- BREAST LIFT – (with or without implants) to restore shape, perkiness and volume
This suite of surgeries targets the changes the body often undergoes as a result of one or more pregnancies, or for a patient interested in the combination of multiple procedures, as listed above. The goal is to restore a youthful, firmer profile, while fortifying self-confidence.
Is It Okay To Have Liposuction Before Having Kids?
While there are typically no major risks associated with becoming pregnant after liposuction, it is typically recommended that patients wait until they are done having children before undergoing the procedure. Doing so can help ensure the results achieved are not compromised by the bodily changes that often occur during pregnancy.
Why Are My Liposuction Incisions Still Oozing?
Small incisions are made for the Liposuction procedure. Generally, fluid will leak out from these incisions for two (2) to four (4) days after the procedure, however, leakage could occur for up to several days. Most of the leakage will be the fluid that was injected to the area for the liposuction procedure. Incisions can heal anywhere between two (2) and five (5) weeks after surgery.
Why Are My Results Uneven?
Post-op asymmetry is NORMAL. Pre-existing asymmetry will continue since the human anatomy of left vs. right does not always match. Human tissue is naturally asymmetric. This applies to Breasts, Face, Eyes, and even the Nose.
Why Is My Swelling Lasting Longer On One Side?
This is very common. The function of your Lymphatic System (which acts as a highway of Arteries, Veins, and Lymphatic Channels) is to filter out fluid from particular areas of the body. Lymph Nodes, Bone Structure & Tissue Shape are different from right to left, so when it comes to draining, the “clearance rate” of the swelling is also entirely different on each side. The heart is located on the left side of the body and distributes blood throughout the body using different paths & pressures. The drainage of the heart is not completely linear; thus, another reason why Lymphatic Clearance is different on each side.
How Soon Can I Take A Shower?
We recommend waiting forty-eight (48) hours to shower. Make sure you are steady on your feet. Do not soak the incisions and pat them dry when done.
Can I Get My Sutures Wet?
After forty-eight (48) hours, stitches can get wet. It is highly recommended, however, that only normal saline (over-the-counter medical cleaning solution) is used to clean the stitches. DO NOT use any cleansers or alcohol products on the suture site. Picking or pulling at the sutures is not approved and can cause damage. Pat the sutures dry if need be.
How Often Can I Apply Heat And Cold Packs?
Hot packs are NOT recommended due to a side effect of increased inflammation which can further delay the healing process. However, cold packs are recommended with frequent usage in fifteen (15) minute intervals.
What To Do If I Become Constipated?
Reduce Norco usage, walk around, and take an over-the-counter medication like Colace or MiraLAX. It is recommended that you start using an over-the-counter stool softening medication one (1) day before surgery and continue taking it until you no longer need to be taking Norco for pain.
How Soon Can I Get On A Plane?
Every case is unique. Typically, short distances (short domestic flights) are okay. However, we recommend that you wait until you see Dr. BYUN’s team at the one (1) week follow-up appointment for final approval. Please keep in mind that extra swelling can occur due to pressure changes in the plane.
BYUN Post Operative Information & Care
Instructions for Liposuction 360
MEDICATIONS TO HELP WITH NAUSEA
ZOFRAN (or OTHER ANTI-NAUSEA MEDICATION): Take one (1) Zofran tablet (or other anti-nausea medication) as prescribed on your way home from surgery.
MEDICATIONS TO HELP WITH INFECTION
KEFLEX (or OTHER ANTIBIOTIC MEDICATION): Start the antibiotics as prescribed (make sure to consume food when taking any antibiotics as it can cause nausea). It is crucial to complete the ENTIRE course of antibiotics.
MEDICATIONS TO HELP WITH PAIN
TYLENOL & MOTRIN: Start with two (2) extra strength Tylenol (take every 6-8 hours). You may take Motrin instead of Tylenol if preferred. Do not take Tylenol and Norco within the same 6-8 hour window. Taper off medication as tolerated.
NORCO (or OTHER PRESCRIBED PAIN MEDICATION: If pain is not controlled with extra strength Tylenol or Motrin, take one-two (1-2) tablets of Norco instead (take every 6-8 hours). DO NOT DRIVE if you’re taking Norco as it can cause drowsiness and other side effects. Norco has Tylenol in its composition – AVOID TAKING NORCO WITH TYLENOL and/or MOTRIN in the same 6-8 hour window.
METHODS & MEDICATIONS TO MINIMIZE BRUISING AND SWELLING
ARNICA TABLETS & BROMELAIN (over the counter): Take one (1) week before and continue for one (1) week after surgery.
ICE THERAPY: Fifteen (15) minutes on, fifteen (15) minutes off. Icing is most important in the first forty-eight (48) hours post-surgery. Icing will still be effective after that forty-eight (48) hour period and is still recommended.
COMPRESSION: Firm but gentle wrapping with ace bandages.
METHODS TO ENHANCE RECOVERY
PROTEIN INTAKE: Protein can be ingested in any form; powder, shakes, bars or foods high in protein.
HYDRATION: Increase water intake (i.e., Pedialyte hydration packets to put in water) & Electrolyte drinks (i.e., Vitamin Water).
CLEANING WOUNDS TWO (2) to THREE (3) TIMES A DAY: Not cleaning enough can cause infection while cleaning too much can take away good, healing tissue and prolong recovery.
MINIMIZE STRESS: Stress leads to inflammation and can delay healing.
METHODS TO DECREASE NAUSEA
HYDRATION: Hydrate the day before with clear fluids. NO FOOD or WATER 8 hours prior to surgery, but you may hydrate before the 8 hours.
MEDICATIONS, CHEWS & FOODS
Take anti-nausea medications (Zofran, or other prescribed anti-nausea medication).
Try ginger candy or a flat ginger ale drink.
Avoid strong scents and smells, or food odors.
Eat slowly and in small portions.
Do not lie down flat after your meal for two (2) hours.
Return to normal foods slowly (please refer to the steps below):
- Start with CLEAR LIQUIDS (water)
- Move into a SOFT DIET (applesauce, pudding, etc.)
- Return to a REGULAR DIET
IMPORTANT: A full diet can be introduced ONLY when the others are successfully tolerated.
IMPORTANT: Start with room temp food – the hot temperature of the food may cause nausea.
ACTIONS TO AVOID AFTER SURGERY
AVOID HEAT THERAPY: Heat expands the tissue and can ruin the surgical work.
AVOID TOO MUCH ACTIVITY: Increasing heart rate and blood pressure can worsen swelling and fluid build-up.
AVOID MASSAGING THE SURGICAL SITE unless told to do so by our medical team.
AVOID TAKING BANDAGES / ACE WRAP(S) OFF: DO NOT remove bandages until after forty-eight (48) hours, or as instructed by our medical team. If ACE wraps are not worn correctly, original surgical results may not be maintained.
AVOID LAYING ON ONE SIDE: Laying on one particular side can cause an increase in swelling on one side of the body, can worsen asymmetrical appearances, and delay the healing process.
WHAT TO AVOID AFTER SURGERY
AVOID Twisting or Bending at the Waist.
AVOID Heavy Exercises.
AVOID Strenuous Activity for at least two (2) weeks.
DO NOT Lift Objects over 10lbs.
Be Kind to Yourself and Trust the Healing Process
BE PATIENT – swelling can take a few weeks to months to decrease.
SORE THROAT feeling from the Endotracheal Tube placed by the Anesthesiologist, resolves within in one (1) to two (2) days, using ice chips or hot tea will help to soothe sore throat.
PLEASE NOTE – If surgery is more than five (5) hours, the anesthesia team may insert a catheter to monitor your body fluid during surgery, the catheter is removed at the end of surgery, discomfort is normal and present for twenty-four (24) hours.
SENSATION, NUMBNESS and TINGLING is NORMAL – new nerves awaken and grow after muscle repair, it may take up to six (6) months to one (1) full year for normal sensation to return.
BLEEDING within the first twenty-four (24) to forty-eight (48) hours is NORMAL.
BRUISING can appear away from the incision, this is NORMAL – bruising will change colors as it heals.
PUCKERING after surgery is NORMAL and a great sign – this shows that your muscles are adhering to the tissues, do NOT massage the puckered areas
ON THE WAY HOME: Take anti-nausea medication.
UNTIL ONE (1) WEEK FOLLOW UP: Start antibiotics (take with food like yogurt, applesauce, or crackers) and start pain management.
PAIN MANAGEMENT OPTIONS:
Tylenol Extra-Strength & Motrin: one (1) to two (2) tablets / capsules, alternating every six (6) to eight (8) hours.
For Intolerable Pain: Norco, or other prescribed pain medication (take with food and as directed).
DO NOT drive and DO NOT mix Norco with Tylenol and Motrin.
If taking Norco, take with stool softener, as Norco can slow down digestion.
AFTER SURGERY: Start stool softener as directed (Colace, Miralax, or fiber supplements). Apply ice to and around the surgical area.
MONITOR SWELLING: The first three (3) days are the worst, the majority of swelling subsides in three (3) weeks.
Elevate legs above heart level.
Start foot exercises – ten (10) times every hour (60 min), this helps to prevent clots.
Start breathing exercises – ten (10) times every hour (60 min), take a deep breath in, hold for ten (10) seconds and exhale.
Perform these exercises at your own pace, helps prevent lung collapse and pneumonia from general anesthesia.
WOUND CARE: To be done two (2) days after surgery – at your forty-eight (48) hour postoperative visit.
BANDAGES & DRESSING:
- Remove gauze and ACE band – DO NOT remove anything directly on the skin.
- Apply Bacitracin / Neosporin to incisions three (3) to (4) times daily to prevent infection and scar depression.
- Once bleeding or oozing has stopped, stop application of ointment.
- Keep the incision clean and dry – use saline and gauze to clean, NO RUBBING.
It is OK to touch the dressing and adjust if it causes any discomfort.
If the dressing is soiled before the two (2) day mark, replace it with a new, clean gauze / ACE bandage.
IMPORTANT: If you have the urge to vomit, sneeze, or cough let it out.
IMPORTANT: If you’re continuously vomiting, call the office.
In The Media
Six things to be aware of before going under the knife.
Dr. Michael BYUN is a serious doctor with seriously comprehensive experience unlike many of his peers, setting him heads and shoulders above the rest.
Chicago magazine profile of Dr. BYUN.