Dr. Edward Zimmerman, MD, owner and Medical Director of Las Vegas Laser and Lipo has built a quality reputation in the Las Vegas community. He has a passion for safely and artfully sculpting and removing extra fat. He is renowned for his interest and experience with laser and liposuction.
Dr. Zimmerman is known as an educator of patients and peers. He is an Adjunct Associate Professor of Cosmetic Surgery at Touro University and aTrustee of both the American and California Academies of Cosmetic Surgery. He is an advocate for the well-being and success of his patients. He was awarded America’s Top Surgeon-2010 and 2012 by the Consumer’s Research Council of America; PSP “Top Doc” in 2010 and 2011, and Excellent Customer Care by CMUS Talk of the Town – 2010-11-12-13-14. He was voted Silver State “Best Cosmetic Surgeon 2013”.
Dr. Zimmerman offers a variety of procedures for individuals who feel a surgical option will best help them achieve the look they desire. One of his most in-demand fat reduction procedures is known as “Liposculpting”. This technique helps to permanently remove stubborn fat deposits that the body seems determined to hold on to.
We asked Dr. Zimmerman to explain what is involved and what can be achieved with the Liposculpting procedure.
Dr. Zimmerman, tell us about the Liposculpting procedure and how it works.
Dr. Zimmerman: Liposculpting is the process of strategically removing and sometimes adding fat to an area(s) to enhance the proportions of the body. What you leave is as important as what you remove!
Who would be the ideal candidate for this procedure?
Dr. Zimmerman: This would be a person in good health. Probably a person in their late teens but more likely in their early thirties to somewhere in their sixties. It’s really a state of health rather than a chronologic age. This individual has a disproportional area of fat that they have been genetically coded or inherited from their parents. Fat has a propensity to gather in that area no matter what. When that area gets out of proportion with the contours of the rest of the body, liposculpting can help.
You have several different types of instruments and liposculpting techniques. Can you elaborate on how these work to achieve a desired result?
Dr. Zimmerman: Lipo is very much like sculpting. You use different tools to optimize the result. If you only have one hammer all the nails look alike, right? If you have multiple hammers, then you can pick and choose the best tools to achieve the optimal result for the patient.
We utilize a number of different tools. The basic tool is a rotary, powered, liposculpting cannula. A cannula is just a long tube with a series of openings in the tip that has a suction hose applied to it. If you slide a liposculpting cannula back and forth through the fat without any pressure to push the fat into the holes, not a whole lot happens. During the procedure, the “smart” hand rests on top of the skin and strategically pushes the fat containing tissue towards the cannula as the cannula glides back and forth under the skin, guided by the “dumb” hand. The liposculpting cannulas I use are pretty small—3-5mm. The small insertion sites for the cannulas are hidden in skin creases, belly buttons etc. whenever possible. If somebody is a performer we have them bring their costume in, so we can hide insertion sites where they are going to be covered by their costume.
Can liposculpting be done with minimal down time? What can someone expect after the procedure?
Dr. Zimmerman: It really depends on the invasiveness of the procedure. If you’re removing two or three teaspoons of fat under the chin, we use a tiny cannula through three or five carefully placed insertion sites that end up looking like a pinholes. They heal quickly and the improvement is visible in days. Their down time is very minimal. Neck lipo is done in the office without much except tumescent anesthesia, but most of my patients like to be more relaxed, so we offer conscious sedation.
You can do liposculpting followed by radio frequency or laser to “shrink-wrap” the skin and tissue tighter. Then patients wear a compression band—a non-latex, elastic band that wraps under the chin and above the head. They will leave that on, most of the time, for about six days if they are my patient. There’s social down time. They would not necessarily do a “meet and greet” with their compression wrap, and a bit of swelling and bruising, but they are quite functional and comfortable otherwise.
Then we have a different person who comes in. They are either local or they fly in and have a larger procedure done. For instance, liposculpting circumferential torso (or thighs or arms and armpits). For torso fat, we mark from the infra—mammary crease down to the pubic area all the way around, including the bra roll while the patient is standing. During the procedure, strategically sculpt out up to a gallon of fat at a time.
We may be transplanting some of that fat to the tush or the boobs or the biceps or shins, or wherever it might be needed to enhance contour and symmetry. We use the patient’s own platelet rich plasma (PRP) to ensure the transferred fat has a maximal chance to grow. We use radiofrequency and laser to tighten the tissue—sort of shrink wrap it, if needed too. That patient wears custom made compression garments for about 6 weeks, to minimize swelling and be sure the tissue re-attaches smoothly.
Patients with large volumes of fat sculpted out have two or three days of true down time where the remaining tumescent fluid is leaking out into absorbent pads or processed by the body. Tumescent fluid is used to fill these people up like a balloon, safely numbing the tissue for many hours. These patients are very comfortable and can help turn, stand and flex so you get a better result. Patients are called that night and for several days, and then rechecked in the office. Weekly lymphatic massage and sometimes low level laser therapy, helps the patients feel and look better sooner. There is social down time that becomes increasingly less. Results are reviewed at about 6 weeks and again at 3 months. They will continue to smooth and blend for up to a year.
In order to do the surgery at an Accredited surgical facility/office like mine, some patients need to have the surgeries split up for safety and optimal outcome. If they have a lot of fat or they don’t actually weigh much but they want to treat a lot of areas, we can only use so much lidocaine—the numbing agent, per kilogram of body weight. And we only remove a safe amount of fat at one surgery (depending on the patients weight and height) in order to keep the procedure safe enough for the patient to walk out of the office and be home with someone to help them the first day rather than have to be admitted to a hospital for supervision after an elective aesthetic surgery (that greatly increases the cost of the surgery and possible risks). A second procedure can be performed as little as 2 weeks later to assure everything they want gets done safely and comfortably.
Once the downtime has been taken care of what do you recommend to preserve the results of the procedure?
Dr. Zimmerman: There are a number of things we do. Obviously we talk about diet and exercise. Along with diet we recommend a pro-biotic. The gut is the largest lymphatic organ of the body. One of the reasons people may get fat and stay fat is because their body is protecting them from all of the toxins they have been exposed to or eaten or imbibed over the years.
When we do liposculpting we liberate hormones and toxins that are encased or suspended in those fat cells. Initially we like to get people on a detox, we certainly like to push fluids and get them into a higher protein diet. We offer a 29 gram, branchchain amino acid shake as a meal replacement to get to and maintain ideal body weight. I’m not really so concerned about weight as opposed to how they fit in their clothes and their overall health.
What do you think is the biggest consideration someone should make when deciding if Liposculpting is right for them?
Dr. Zimmerman: I think any person who wants do to an elective cosmetic procedure, does it for the right reasons. They are realistic and have a good support system. They have to recognize that liposculpting is not a treatment for obesity, though it can certainly help jump start someone who has plateaued on their diet or someone who wants to get started and needs that immediate gratification.
It helps a lot with body image, but we have to be careful we don’t use a surgery for someone who’s truly body dysmorphic. The treatment for those individuals is not cosmetic surgery, it’s getting those folks to a clinical psychologist or psychiatrist who can help them.
Doing multiple surgeries on someone who doesn’t have the ability to be happy with their appearance no matter how good the results, is doing more of a disservice.
We spend a great deal of time educating patients to assure they understand what’s reasonable to expect, that “perfection is the enemy of good” and we all are born with asymmetries and contours that could be better. That is actually part of our Beauty and should be embraced…. None of us are perfect….that’s ok… Mother Nature doesn’t make mistakes.
She does allow for enhancements…that’s our passion!
Dr. Zimmerman, thanks for the insight into Liposculpting.
Dr. Zimmerman: It’s been my pleasure.
Dr. Edward Zimmerman, MD, Las Vegas Laser and Lipo can be contacted directly at 702-360-6686. His business website is zimmermanmd.com.
Kevin Nimmo is a writer and online media strategist. He interviews subject matter expert and educates his readership based on information provided by experts in their respective fields. He is also Executive Editor of The Western Medical Journal.