Wonderful New Device Has Been Invented to Improve Liposuction Results

Have you heard of the abrasive cannula that is used by all the advanced liposuction surgeons these days? This cannula helps us spread the fat around and make the surface much more even after liposuction. What we do is at the beginning of the case, we use this special instrument in order to abrade and loosen the fat after insertion of the local anesthetic. Then the fat is suctioned and the patient is checked while standing. Any areas that are improper or irregular are marked with a sterile Sharpie marker and the patient is then put back on the operating table and sedated again so they don't remember or feel anything during the case.

The special cannula is again used and sometimes a bit more suctioning is performed. After this, foam and the specially designed compression garment is applied and the patient is allowed to wake up and given fluid to recover. 

We hope this detail isn't too technical for you. Some patients would rather not hear about it, but we think that this helps some people learn more and understand more and have a better feel for what is happening during surgery.

X Marks the Spot:  A New Gynecomastia or "Man Boob" Removal Technique

Dr. Yoho recently attended a medical conference for advanced cosmetic surgery in Buenos Aires, Argentina. There he learned an excellent technique for improving the results in gynecomastia surgery. Dr. Blugerman, just like Dr. Yoho, aggressively liposuctions the area around the problem using a special local anesthetic. After this is performed, instead of making an incision in the lower part of the nipple of the areola right at the junction of the skin, an X is incised right through the middle of the nipple areolar area. Oddly enough, these come together and look fantastic after the surgery, rarely causing problems of any kind, and in most cases making much smaller incisions and leaving no scars.

That said, remember that fluid buildup and sometimes a little bleeding into the area is not that uncommon with gynecomastia surgery. Be prepared to follow up closely with Dr. Yoho when you have your "man boob" improvement procedure, because occasionally this fluid needs to be removed postoperatively in order to get the best result possible and avoid complications such as infection.

The "Gummy Bear" Implant is a Failed Implant

Unrelated to Gummy Bears or implants

The claim with the gummy bear implant is that if ruptured, the silicone on the inside will not bleed into the surrounding tissues. This is a patently false proposition, because those of us who have taken out gummy bear implants which have been ruptured have seen the silicone spread in just exactly the same way that a gel implant or an ordinary silicone implant's contents will leak out of the implant shell. So therefore this is not an advantage. 

The other advantage claimed for the gummy bear implant is the lower capsular contracture rate. This is a falsehood, because the gummy bear implant is naturally as firm as if the patient already had a Class II capsule or a quite firm breast. Therefore, the Class II capsules aren't counted in the statistics, and this distorts the perception in the studies that the gummy bear implant is superior. 

We think the gummy bear implant is too firm to be very natural and not a good choice in general for anyone. We like gel implants. We don't believe they have a higher capsule rate than saline implants, and their only problem is their expense. A new device that allows us to put them in more easily and damage them less is a great help to their placement. This is the "Keller Funnel", and we have had a great deal of satisfactory experience with it in easing the insertion of our implants, using a smaller incision for the implant's placement, and lowering the chance that we will distort the implant shell in some way, thus leading to a higher chance of rupture later in the patient's history. 

Please feel free to come in for your consultation in Los Angeles or Visalia in regard to these issues and chat about the various options in regard to silicone and saline implants.