An Indepth Look at the SmartLipo Process, By Cynthia Abbott, MD

It’s always good to see an old friend, and that is how it was with Geonni. I had treated his lower abdomen with Smartlipo four years ago, and now he was back for more. Geonni, usually a very active person, had experienced a sports injury and had been unable to work out for months. His lower abdomen still looked great, but he was depressed when he walked into the gym. He had put on about 10 pounds that he couldn’t get off on his flanks and upper abdomen.
He wanted to do Smartlipo again, and had tracked me down as I changed practices. It made me feel great when he said he only wanted me to do it, although there are several Smartlipo surgeons around. He searched for me. He was going home to Costa Rico for a family event in 2 weeks to see many old friends and wanted to look good…. fast. This was Monday…could we do his case Friday?
Geonni was an excellent candidate. He knew he needed to wear a garment for one week 24/7, then he could reduce wearing it to about 12 hours per day intermittently. I told him he couldn’t get in the water for 2 weeks, and sun exposure during the immediate healing period was discouraged because of potential darkening of the skin from the sun in an uneven fashion. He was motivated, and promised to follow directions. So we scheduled his surgery for the end of the week.
Although I have been doing Smartlipo for almost five years, and had been trained to do regular liposuction for almost 15 years, some of my new office staff had not seen the procedure before. My experienced nurse of four years asked Geonni if he would be willing to let some of the staff watch. He didn’t mind, and probably enjoyed the extra attention!
On surgery day, the excitement was evident. He was ready to get rid of his extra fat. Each area was only about as large as the palm of my hand, but they bothered him. Pictures were taken; he was marked and given one Vicodin to take the edge off of the numbing. Since he knew what to expect, he used his iphone to catch up on emails during the surgery. He requested ELO music playing in the room during the surgery.
Geonni was happy to answer any questions about how it felt during the surgery. The numbing was a little uncomfortable as we infused the saline/lidocaine solution, then we dimmed the lights and all watched the little red light from the laser under his skin as it melted the fat. Geonni was fascinated, since we could actually see the laser light melting away his fat.
During the laser treatment, the cannula moves easily through the tissue melting fat like butter with very little trauma. After the laser application, the room lights were turned back on and I started suction to remove his melted fat with a small liposuction cannula. Geonni found this a very satisfying part of the procedure, as he could say goodbye to his fat and watch it as it went through the tubing to the waiting collection canister.
Sometimes we would talk about what a good fat pocket we were emptying, judging by the copious amount of butter colored fluid streaming through the tube. We discussed world events, summer plans, music: we had a great conversation, as he is quite a chatty person. This isn’t always the case. Sometimes patients would rather doze off or just close their eyes and disappear into their music. Some patients want to know everything that is happening, and some patients would rather not know or see anything. I try to make patients comfortable with their experience.
Afterwards, my nurses and I felt for any areas we may have missed. He did a sit up and we all looked to see if everything looked even. We found a small area near his belly button that needed a bit more work. Geonni was so excited as he did his sit up, joking that he had always known there were muscles there! He thanked us for taking his fat blanket off so he could see his rock hard abs again. A bit of an exaggeration, yes, but the nurses were astounded at the noticeable improvement.
I put in a dissolvable stitch over each incision site and covered them with paper tape. We then helped him get into his garment. Little pads were placed under the garment over the lower incisions to catch any drainage over the next 12-24 hours. We gave him a couple of extra pads in case he needed to change them later that evening.
We called our insured and bonded driver to take him discretely home, as the surgery was a secret from even his closest friends. I do not allow patients to drive themselves home, even without pain medication, as fluid shifts can cause unexpected dizziness during the first 12 hours. I have had patients from out of town who have felt great after SmartLipo and wanted to take advantage of a great shopping sale. I allowed them to go shopping only if they stayed right with their friend and driver in case they felt dizzy. Patients don’t have any pain post-procedure, although some may be sleepy, depending on the medication used during SmartLipo.
Generally it is best to just go home and relax for a day or two, as the dressings are bulky the first day and soreness will occur after the numbing wears off in 6-12 hours. Frozen dinners and a movie are a great idea that first evening.
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