How long does it take for the swelling to go down after liposuction?

I often hear this question from prospective patients at my Los Angeles liposuction practice.  The answer is that it depends.

Liposuction traumatizes the fat during removal, and swelling develops as a result of this trauma.  Although it is safe to say that swelling can take up to 6 months to resolve, it can diminish much faster than that depending on the technique used, the individual healing characteristics of the patient, and the amount of fat removed.

In terms of technique, adequately infiltrating the area to be suctioned with anesthetic, using microcannulas, and leaving the entrance ports to drain under compression after the procedure make the biggest differences.

To ensure adequate infiltration, I use liposuction using local anesthesia only.  I also only use microcannulas which are very small versions of the suction tubes used to extract the fat.  The smaller the tube, the less trauma there is.

Compression after surgery forces the excess fluid out of the entrance ports made during surgery.  These are so small they do not require stitches.

Swelling generally lasts longer when a lot of fat is removed.  In my experience, swelling also seems to resolve faster in certain areas, especially the arms.

Using these techniques, I tell prospective patients in my liposuction Los Angeles practice that, for most people, the great majority of swelling will be gone by 6 weeks but  some residual swelling may last for up to 6 months.  However, I’ve never had a patient whose area was bigger from the swelling than it was before surgery.

What Causes Dark Circles Under the Eyes?

Dark circles under the eyes are a common complaint, and their appearance is likely due to multiple factors that include genetic hyper pigmentation, excess pigmentation due to inflammation from allergies/eczema, swelling, thin skin allowing blood vessels and eye muscles to be visible through it, and anatomical changes leading to shadowing such as depression of the tear trough.  Each one of these causative factors needs to be addressed for maximal improvement.

To treat hyper pigmentation, one may benefit from chemical peels and the regular use of sunscreen and bleaching creams.  If the increased pigmentation is due to inflammation from allergies or eczema, then the allergies or eczema need to be treated.

Muscles and blood vessels are dark in color, and they impart a darker tint to the overlying skin when they are able to be seen through it.  Thin lower eyelid skin is difficult to treat, but chemical peels and prescription creams such as tretinoin (Retin-A) can help.  Thick skin is less transparent.

Anatomical changes that lead to the appearance of a shadow under the eye include a depression in the groove along the lower eyelid.  This groove is known as the tear trough.  When this groove extends onto the cheek it is because the fat pad that creates the apple of the cheek has descended.  These anatomical changes occur with age.  The tear trough can be filled with products such as Restylane and Juvederm.  In my experience, this is a very rewarding procedure.  The cheek can be re-volumized with many different products, but one of my favorites is Radiesse for cheek augmentation.  Protrusion of the fat pads directly behind the lower eyelid often need to be addressed surgically if they are very prominent.

In my Los Angeles Dermatology and Liposuction practice, patients often ask me what they can do about dark circles under their eyes.  Although it is not always possible to completely eradicate them, many people can achieve significant improvement if the individual factors causing them are addressed.

Don’t Sweat It! Here’s a tip for treating excess underarm sweating.

Excess underarm sweating can be debilitating.  Prescription antiperspirants and Botox for sweating can help, but here’s a tip for getting results with over-the-counter “prescription strength” antiperspirants.

These are products like Gillette Clinical Strength and Secret Clinical Strength.

Instead of using these antiperspirants in the morning like most people do, apply them to clean and dry skin both morning and night.  One study evaluated 60 women and found that antiperspirant applied twice per day was more effective than application in the morning or night only.*

Of course if over the counter antiperspirants don’t work despite applying them twice per day, there are prescription products and Botox available.  At our Los Angeles dermatology practice, we are able to prescribe strong antiperspirants and regularly administer Botox for hyperhidrosis.

* Swaile DF. Clinical comparison of antiperspirant efficacy as a function of morning and/or nighttime application.  Journal of the American Academy of Dermatology. 2004 Mar;50(3);p77.

Botox Finally Has a Competitor

After years of waiting, there is finally an alternative to Botox Cosmetic.  It is called Dysport, and, like Botox, it is botulinum toxin A.

Dysport recently received approval for medical and cosmetic use in the United States.  Although it is new here, it has been used for a number of years outside of the US, and the medicine is 18 years old.

There are some differences between Botox and Dysport even though they are both forms of botulinum toxin A.  The molecule of Dysport is smaller in size than that of Botox.  This may account for the observation that Dysport spreads farther in the skin after it is injected.  Also, more units of Dysport are needed per injection than Botox to achieve the same desired result.  The company that distributes Dysport recommends a conversion ratio of 2.5 units of Dysport for every 1 unit of Botox.

Another difference between the two products may be in how long their effect lasts.  One study comparing Dysport to Botox found that Botox seemed to last longer.

A separate issue is the potential to develop proteins against these products called antibodies.  Proteins against Botox have been reported which may account for the observation that some people become resistant to treatment over time.  The US distributor of Dysport reports that no antibodies developed in patients receiving Dysport in clinical trials even after 9 treatments.

What these differences mean in the real world remains to be seen and will probably be discovered after a few months of use.  Medicis, the distributor of Dysport, expects to begin supplying Dysport mid-July.  The exact date of distribution will depend on how quickly the medicine passes through customs since it is being imported.

For those residents of Los Angeles, I will have Dysport in Los Angeles available in my Los Angeles liposuction & dermatology practice as soon as it is available.

Latisse Grows Thicker, Longer Eyelashes

Latisse is the first FDA-approved medicine used to grow eyelashes.

Latisse is applied to the upper eyelashes daily using a sterile, disposable applicator. If treatment is stopped, eyelashes return to the length they were prior to treatment.

The active ingredient in Latisse is called bimatroprost, and it was discovered to grow eyelashes accidentally after patients using this medicine to treat their glaucoma noticed that their eyelashes grew.

Side effects of Latisse include eye redness, itchy eyes, darkening of the eyelid skin, and, possibly, permanent darkening of the colored part of the eye.

Latisse is manufactured by Allergan.

To learn more, you may visit our website at www.drosman.com or schedule a consultation if you live in Los Angeles for Latisse in Los Angeles.

Evolence Los Angeles

Evolence is a new collagen based dermal filler. Collagen is the most abundant building block of our skin and is lost during the aging process. Evolence is strategically placed into the dermis, like other fillers, to enhance and maintain the natural structure and volume of our skin.

Unlike other fillers such as Restylane or Juvederm that are made of hyaluronic acid, Evolence Los Angeles is composed of collagen. The collagen structure of Evolence tends to cause less bruising and swelling than the hyaluronic acid fillers making recovery quicker and easier. Unlike older collagen fillers, Evolence does not require skin testing prior to use. This means you can get treated right away.

As a board-certified dermatologist in Los Angeles experienced with many fillers, I offer Evolence in Los Angeles.

Compression Garments After Liposuction

Many prospective patients at my Los Angeles liposuction practice ask how long they must wear their compression garments after their procedure. They’ve heard that it can be as long as six weeks.

Needless to say, they are often surprised and happy to learn that most patients only have to wear their garments for 3 – 5 days. Using local anesthesia only and microsurgical instruments allow such a short duration.

Garments are worn to facilitate drainage of the anesthetic solution used in the procedure which speeds healing. They do not need to be worn after drainage has stopped, and wearing them longer does not alter the final cosmetic outcome.

Such a short duration makes modern liposuction (also referred to as liposculpture) a much more feasible procedure for people “on the go” in this day and age.

Hand Rejuvenation

Without rejuvenation, the hands are a dead giveaway of someone’s age. Fortunately, several procedures can dramatically improve the appearance of aging hands.

Hands appear aged for several reasons. The two most important are: 1) sun spots and areas of discoloration appear, and 2) the hands lose volume with time which causes veins and tendons to become more visible.

Laser treatment, chemical peels, and cryotherapy reduce the presence of sun spots and localized discolorations; while, Radiesse and Sculptra replace lost volume. All of these treatments have minimal to no downtime.

Of course, no discussion on rejuvenation of the skin would be complete without mentioning sunscreen, so remember to apply it on your hands daily as well.

Less Is Often More With Liposuction

One request I hear very frequently from patient’s during liposuction is to remove as much fat as I can. It’s important to know, though, that this will not provide the best results. The best liposuction results are achieved when just the right amount of fat is removed.

Actually, removing as much fat as possible is easier than removing just the right amount of fat. That’s because liposuction, or liposculpture, is a medical procedure for body sculpting, and sculpting of any form is art. The end goal of liposuction is to remove extra fat that appears disproportionate to the rest of the body in order to achieve a more pleasing contour.

A focus on achieving balance and proportion doesn’t mean that a dramatic change cannot be achieved. In fact, most patients do experience a dramatic change after liposculpture. It does mean, though, that liposuction is about more than just removing as much fat as possible. It’s about removing just the right amount of fat!

Liposuction Combined With Thermage Enhances Skin Tightening

Liposuction using local anesthesia, called tumescent liposuction, is the safest and most effective procedure for removing fat. Although most patients with loose skin before surgery will notice some degree of tightening after liposuction, they may still have a certain amount of loose skin after the procedure.

Now there is a non-surgical way to further tighten loose skin after liposuction. Thermage is a radiofrequency device that heats the collagen in the skin which causes skin to tighten. At my Los Angeles liposuction practice, I use Thermage in combination with liposuction to maximize skin tightening. It is especially useful for certain areas such as the abdomen, inner thighs, and neck.

There is no downtime with Thermage, and it is usually a one-time procedure. However, it can be repeated if desired.