S. Larry Schlesinger, MD, FACS Performs Liposuction – Part Two of The Ultimate Silhouettplasty®. Ultimate Silhouettplasty®, the process to safely address skin and fat on the abdomen.
This is the front side of the Ultimate Silhouettplasty®. She’s already had a tummy tuck, the incision is very low. She’s not really overweight person, but that last little bit is very valuable. It gives her a tighter waistline.
And so what I’ve found is you make two incisions in the pubic area. You make three inside the belly button and the key to this whole thing is never go through the incision. Because if you go into the incision it’ll just open up. So go into the umbilical tissue proper.
OK, and then you are going to make two incisions up here. And the reason for this is you can’t come straight up the middle because if you do you will take apart your rectus repair and if there wasn’t a rectus repair you’ll take apart the normal white line in the middle.
So we go at the edge of the rib, right here. So there’s a total of seven incisions made. And we put the tumescent in.
And now get down into the flanks because you can take out some scar tissue that occurred after the first liposuction of the flanks. And when you hollow it out you get a better waistline. And again when we are liposuctioning up here we go on the diagonal so we can use that to put the tumescent in as well.
So we are now liposuctioning the abdomen that’s already had an abdominoplasty. Whenever you do liposuction/tummy tuck combination do the tummy tuck first and the liposuction second. There’s always exceptions to that rule, but I think it’s a good rule. And I believe in it and it’s worked for me and my patients.
You see that waistline coming in there and how this one, of course it’s got tumescent in it, but this one is not anywhere as delicate and attractive as that one is.
And you want to go all the way around the umbilicus as people tend to miss the periumbilical fat in their liposuction so going around the umbilicus is a good thing. Get through to that periumbilical fat that’s often residual after a liposuction of abdomen.
And a wonderfully flat stomach that she’ll be really proud of to take to the beach.