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Ultrasonic Assisted Liposuction a Key to Unlocking Fat

If you have tried everything to lose weight but still have a bottom that would make Rubens smile appreciatively or a love handle that will not go away, ultrasonic assisted liposuction (UAL) -- a new cosmetic surgery technique being offered by Joseph O'Connell, M.D., -- may be the remedy.

The chief of the Plastic Surgery Center at Bridgeport Hospital, Dr. O'Connell is a longtime Connecticut resident and maintains a private cosmetic surgery practice at 208 Post Road West, where he recently spoke about UAL while awaiting the arrival of "Nicole," a 30-something sales representative from Westport who was going to have the procedure done on her buttocks and thighs later that day.

In his office, where one wall is filled with his professional credentials -- Dr. O'Connell received his medical degree from Cornell University Medical College and completed a five-year residency in general surgery prior to his residency in plastic and reconstructive surgery at New York Hospital/Cornell Medical Center, where he also served as chief resident in plastic surgery at the Memorial Sloan-Kettering Cancer Center; is certified by the American Board of Plastic Surgery and the American Board of Surgery; and is a fellow of the American College of Surgeons -- he began by offering a short overview of liposuction, which was developed in France in the 1970s.

In conventional liposuction, a small incision, which is later hidden as the skin around it heals, is made and a hollow titanium rod called a cannula is inserted. The cannula, which is about as thick as a straw and has vents on its side, is connected to a pump so that as the surgeon moves it back and forth and in circles under the patient's skin, he pushes through the fat deposits and vacuums the chunks away, Dr. O'Connell said.

In addition to removing fat, however, traditional liposuction often removes surrounding connective tissues and blood vessels, Dr. O'Connell said, and is not practical for large, fibrous areas such as the upper abdomen, back and breasts.

Dr. O'Connell, who has performed "thousands" of cosmetic surgeries in Fairfield County since 1988 and "hundreds" of UAL procedures since March, said UAL is similar to traditional liposuction but is done with a cannula equippled with a probe that produces very high-frequency sound waves, which cause fat cells to implode instantly and melt before being vacuumed out by the rest of the rod.

"Sound waves do the work and make fat cells release their oil, and an unexpected benefit of UAL is that it works like a paint gun, giving a smoother result than traditional liposuction," he said. UAL also results in less bruising, quicker recovery and more skin shrinkage, he said. Many American plastic surgeons, however, may continue to use conventional liposuction because UAL is still relatively new to this country, although the technique has been widely practiced in Europe since the late 1980s.

Neither conventional liposuction nor UAL, however, is a substitute for losing weight through diet and exercise, Dr. O'Connell stressed. But for those who have a genetic or hormonal predisposition to accumulating fat in specific areas of the body -- hormones account for 80 percent of the fat that women gain in their thighs and hips, he said -- it can definitely help.

"People can be in incredible physical shape but can't burn fat off in some parts of their body," Dr. O'Connell said, citing as an example Nicole, who exercises regularly but still has fat deposits that won't go away.

Nicole is an ideal candidate for UAL, he said, because she is already close to her ideal body weight, has no pre-existing medical conditions that could be complicated by the surgery and has no illusions that removing fat will change anything about her save the shape and size of her body. Elective cosmetic surgery is almost never paid for by insurance, he said, and the cost of UAL for hips and thighs runs between $3,000 and $5,000, while liposuction of the stomach area is approximately $3,000.

Getting Down to Business

In addition to a barrage of question's in each patient's initial interview, Dr. O'Connell makes a video recording of the patient's body, then loads the tape into a computer modeling program. The images of the look the patient wants to achieve are then printed out and used by Dr. O'Connell during the surgery as guidelines.

When the time for her surgery came, Nicole admitted she was "definitely nervous."

"I'll definitely feel happier if we get the desired results, especially if I can be wearing a bathing suit" and looking good in it this summer, she said.
But before she entered the operation room and disrobed -- no, UAL is not for the modest; "you get embarrassed with your priest and your plastic surgeon," Dr. O'Connell said -- Nicole and the doctor went over an extensive consent form.

"We're changing your body permanently," he told her. Regarding the "unknown risks" of the surgery, Dr. O'Connell said, "we don't know the long-term effects of UAL."

Dr. O'Connell's humor, however, belies his concern for the mental and physical well-being of his patients.

"We take great extremes to minimize risk," he said, explaining that Nicole had been scrubbing with anti-bacterial soap for three days to lower her body's bacteria count and would receive two antibiotics during the surgery.
Because the greatest risk of injury to a patient in any surgical procedure is in using anesthesia, Dr. O'Connell eschews the drugs that depress the central nervous system and knock the patient completely out. Instead, he uses mild sedatives to make the patient gently nod off but keep breathing under his or her own power, and a very-short-acting local anesthetic.

In the operating room, a clinical registered nurse anesthetist monitored Nicole's vital signs -- a defibrillator and other emergency medical equipment were on hand should anything have gone wrong -- while an operating room nurse helped Dr. O'Connell get into his scrub gown. Nicole was lying face down on the operating table, her buttocks and thighs smeared with an antiseptic and marked with contour lines corresponding to the computer images of what she wanted to look like.

Once the initial incision was made, Dr. O'Connell inserted the UAL probe and began what would turn out to be a two-and-a-half hour operation. After Nicole wakened -- very shortly after the end of surgery -- she recuperated for several hours under the attention of a nurse in another room at the office, and for about three weeks she wore an elastic under garment to help control swelling and bleeding and help her skin shrink to fit her new contours.

During a follow-up consultation, Nicole and Dr. O'Connell will review how successful the surgery was and, if necessary, what surgery will be required to help her look the way she did in the computer-modeled images.

While Nicole's surgery was under way, "Susan," a 21-year-old who earlier in the day had UAL done to her thighs, hips, and buttocks, was feeling "a little groggy but OK" in the recovery room.

Ultrasonic Assisted Liposuction a Key to Unlocking Fat

Getting Down to Business

Ultrasonic liposuction plastic surgery article featured in Fairfield Citizen News.

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