VASER liposuction versus smart lipo

VASER Liposuction versus Smart Liposuction - Houston, Texas

December 14, 2017 / Emmanuel De La Cruz

After more than a hundred VASER liposuctions I’ve performed in the Houston area, the fundamental questions asked by the patients about this surgery have remained the same. Therefore, I’ve decided to uncover their inquiries in a series of articles, starting by explaining in what this innovative procedure consists and how much it differs from other fat removing techniques such as Smart Liposuction.

VASER Liposuction is an advanced body contouring procedure that “selectively” remove unwanted body fat. This method uses minimally-invasive ultrasound technology to breaks up fat while leaving all other important tissues intact, resulting in significant desirable effects with minimal damage to surrounding tissues. Consequently, patients recover considerably quicker as they suffer reduced bleeding, bruising and swelling in the treated areas1. The shorter recovery time needed for VASER Liposuction makes it more convenient and appealing to my patients, who may return to their regular lives 1-2 weeks after the surgery and sometimes sooner. Meanwhile, the recovery time expected for Smart Lipo and other liposuction methods exceeds the 2 weeks. Moreover, the major advantage of VASER liposuction as compared to traditional or Smart liposuction would be the significant skin retraction that occurs after this liposculpture procedure.  It’s the only liposuction method that has been proven (based on a randomized clinical trial) to cause skin retraction.  The risk of bleeding and contour irregularities are also significantly lower with the use of the VASER liposuction machine when compared to other liposuction methods.

Another reason why I recommend VASER liposuction over other alternatives is the remarkable advantage of using the extracted excess of fat to transfer it to other specifics areas of the body such as buttocks and/or thighs. This process is called Fast Transfer Procedure or Fat Grafting. It’s important noticing that fat cells treated and removed during VASER Lipo procedures are typically of high quality –in contrast with the ones extracted via Smart Lipo-, and are viable to re-introduce into the body. Unlike short lasting synthetic fillers, re-injecting your own fat may give you natural looking results that last longer, with no risk of rejection.2 This favorable possibility to accentuate and contour your body by using your own fat in a single procedure is definitely one big plus for VASER Lipo in comparison to other liposuction procedures.

Before & After Photos of VASER Hi-Definition Liposuction of the abdomen, back with Biopolymer removal from the buttock and fat transfer to the buttock  performed by Dr. Emmanuel De La Cruz 

References:

1Garcia, O., Jr., Nathan N. 2008. “Comparative Analysis of Blood Loss in Suction-Assisted Lipoplasty and Third-Generation Internal Ultrasound-Assisted Lipoplasty”. Aesthetic Surgery Journal, 28(4):

2Schafer, M.E. et al. “Acute Adipocyte Viability After Thrid-Generation Ultrasound-Assisted Liposuction”. Aesthetic Surgery Journal.

Liposuction cost

Liposuction cost in houston

Dupuytren's Disease and Contracture

What is Dupuytren's Disease?

Fast Facts About Dupuytren's Disease

• It presents as a thickening of the skin of the palm of the hand.
• It's hereditary (Autosomal dominant), especially of "Viking heritage."
• Most common among middle age (40-60) individuals.
• More common in men (Male: Female ratio is 7 to 1.)
• Typically presents with contracture of the metacarpophalangeal joint (knuckle joint) and proximal interphalangeal joint (one of the joints of the fingers.)

Dupuytren's Contracture of the Ring Finger (Photograph Courtesy of Frank C. Muller, Wikimedia Commons)

Associated Diseases

• Epilepsy (most common)
• Alcoholism
• Diabetes Mellitus
• Smoking
• NOT related to manual work.

When would Treatment be Needed for Dupuytren's Disease?

• When there's contracture of the metacarpophalangeal joint or MP joint of >30 degrees
• When there's contracture of the proximal phalangeal joint or PIP joint
• Nodules alone does not need surgery.

What kind of Treatments Available?

• Collagenase injections
• Needle aponeurotomy or percutaneous Dupuytren's Contracture release in selected patients.
• Selective or Extensive Palmar fasciectomy and Dupuytren's contracture release.

I recommend asking one of your Houston Plastic Surgeons about your Dupuytren's disease if it requires treatment or not.

Emmanuel De La Cruz M.D.

Reference:

Badalamente MA, Hurst LC: Enzyme injection as non-surgical treatment of Dupuytren’s
Disease. J Hand Surg 25A: 629-636, 2000.

Burge P, Hoy G, Regan P, Milne R: Smoking, alcohol and the risk of Dupuytren’s contracture.
J Bone and Joint Surg 79B: 206-210, 1997.

Chammas M, Bousquet P, Renard E, Poirier J- L, Jaffiol C, Allieu Y: Dupuytren’s Disease,
Carpal Tunnel Syndrome, Trigger Finger, and Diabetes Mellitus. J Hand Surg 20A: 109-114,
1995.

Critchley EMR, Valcil SD, Hayward HW, Owan VMH: Dupuytren’s disease in epilepsy. J
Neurol Neurosurg Psych 39: 498, 1976.

Ling RSM: The genetic factor in Dupuytren’s disease. J Bone and Joint Surg 45B: 709, 1963.

Starkweather ICD, Lattuga S, Hurst LC, et al. Collagenase in the treatment of Dupuytren’s
disease: an in vitro stud y. J Hand Surg 21A: 490-495, 1996.

Percutaneous Dupuytren's Contracture release

Percutaneous Needle Aponeurotomy for Dupuytren's Contracture ~ Houston Plastic Surgeons

• Percutaneous needle aponeurotomy is a minimally invasive procedure for release of Dupuytren's contracture by dividing the cords percutaneously using a needle.
• A study conducted involving 3736 procedures using this technique reported good results (>70% correction) in 81% of patients
• Complication rates ranges from 3.7 to 8.9% which include nerve injury
• Another study involving 82 patients with 10 year follow-up showed that 2/3 of patients requiring a second release within 5 years
• Recurrence rates of  Dupuytren's contracture after limited local excision ranges from 34 to 66%
• Recurrence rates after extensive excision of the palmar aponeurosis is 11.6%
• Typical recurrence rate after needle aponeurotomy is ~50% in 3-5 years
• Not all patients are candidates for percutaneous needle aponeurotomy
• Long term correction is better maintained in the metcarpophalangeal joint (knuckle joint) than the proximal interphalangeal joint of the finger (70 vs 41%).

I recommend asking your hand surgeon if he/she performs this kind of procedure.  Not all patients are candidates for percutaneous needle aponeurotomy for Dupuytren's contracture.  

Emmanuel De La Cruz M.D.

Reference:

Cheng et al. Needle Aponeurotomy for Dupuytren's Contracture. Journal of Orthopedic Surgery. 2008; 16 (1):88-90

Duthie RA, Chesney RB. Percutaneous fasciotomy for Dupuytren’s contracture. A 10-year review. J hand Surg Br 1997;22:521–2.

Badois F. Non-surgical treatment of Dupuytren’s contracture. Available from: http://assoc.wanadoo.fr/f.badois-dupuytren/html/gbsommaire.html. Accessed 4 December 2006.

Endoscopic Carpal Tunnel Release versus Open Carpal Tunnel Release

Fast Facts About Endoscopic versus Open Carpal Tunnel Release ~ The Woodlands Hand Surgeon

• Endoscopic carpal tunnel release involves a smaller incision (typically 1 cm at the wrist) whereas open carpal tunnel release involves a larger incision over the palm of the hand (~3cm incision)
• Endoscopic carpal tunnel release has the advantage of less scar tenderness and pillar pain
• Patients who undergo an endoscopic carpal tunnel release has a faster grip recovery and earlier return to work in patients who are not recipients of workers' compensation
• In the hands of inexperienced surgeons, endoscopic carpal tunnel release has the potential for higher neurovascular complication rate owing to the technical demands of the procedure and its steep learning curve
• The decision of which procedure to perform is affected by the surgeon's experience and patient factors, which includes occupation, socioeconomic factors and patient's preference
• Studies have shown no difference in complication rates between the two techniques (open versus endoscopic carpal tunnel release)

I recommend asking your hand surgeon, whether they are trained as orthopedic or plastic surgeons, their technique preference as well as their experience in performing the endoscopic carpal tunnel release. 

Emmanuel De La Cruz M.D.

www.delacruzplasticsurgery.com

My Passion in Plastic Surgery ~ The Woodlands Hand Surgeon

Like playing the piano, there are two sub-specialties of Plastic surgery that I am passionate about: Aesthetic (Cosmetic) Surgery and Hand Surgery.  Mastering the smallest detail in anatomy is one aspect that I love about Aesthetic and Hand Surgery.  The meticulous dissection required in a facelift,  rhinoplasty and peripheral nerve surgery is exciting as it is related to the mastery of anatomy and innovative plastic surgical techniques.  The finesse and creativity involved in both cosmetic and hand surgery, such as creating a new thumb or making someone look 20 years younger, are exhilarating.  So what is my secret?  Hand and Aesthetic Surgery are my secret wives.  




Alaskan fisherman who had an amputation of his thumb from a work-related injury.

 


New thumb that Joel Solomon M.D. and I reconstructed using the patient's toe.

 

Emmanuel De La Cruz M.D.

Woodlands Plastic Surgeon

"To create something exceptional, your mindset must be relentlessly focused on the smallest detail."
~ Georgio Armani

Carpal tunnel syndrome ~ The Woodlands, Texas

Fast facts about Carpal Tunnel Syndrome

• The main symptom of carpal tunnel syndrome is numbness of the fingers, especially the thumb, the index and middle finger.
• When carpal tunnel syndrome worsens, this may interfere with hand strength and sensation, and cause a decrease in hand function.  This occurs when the muscles of the thumb become affected and may become irreversible when the carpal tunnel syndrome is not treated for a prolonged period of time.
• Mild carpal tunnel syndrome can be effectively treated with splinting, and temporarily by steroid injections in the wrist.
• When the symptoms of numbness sensation does not improve with conservative treatment, such as splinting, surgery is most likely needed (carpal tunnel release.)
• Two types of carpal tunnel release: Open carpal tunnel release with a large incision, and endoscopic carpal tunnel release with a 1 cm incision or less.

Emmanuel De La Cruz M.D.

Woodlands Plastic Surgeon

The Woodlands Hand Surgeon

Carpal Tunnel Syndrome Articles

1) What is Carpal Tunnel Syndrome

Miscellaneous Articles

1) Thumb reconstruction (Toe-to-Thumb Transfer)

 Emmanuel De La Cruz M.D.

Plastic & Reconstructive Surgery
Woodlands Hand Surgeon 

The Woodlands, TX 77381