Liposuction Data Sheet: Advanced Art of Cosmetic Surgery: Thomas M. DeWire, Sr, MD, FACS

LIPOSUCTION AND TUMMY TUCK

Thank you for you inquiry. Kindly take the time to read ALL of the Liposuction related pages on my WebSite, starting at:
http://www.advanced-art.com/Liposuction-Info.htm , including links to the abdominoplasty sections.

Much of the data you seek is found there, including detailed explanations and rationale for the techniques that I have carefully
developed over the years. I will include a number of data points below:

CERTIFICATIONS:
Certified: American Board of Plastic Surgery
Member: American Society of Plastic Surgeons
Member: American Society for Aesthetic Plastic Surgery

AACS offers a fully certified Ambulatory Surgery Center accredited by: AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities, Inc) with anesthesia services provided only by Doctors of Anesthesiology.

BROCHURES:
We no longer mail brochures, etc., since they are available online. However, the brochure information is generic, and the
information on my pages seems to be far more specific, comprehensive, and pertinent to my particular techniques. Of course,
individual specifics must be identified and addressed at consultation.
The ASPS brochure links for Liposuction are:
Liposuction www.plasticsurgery.org/surgery/lipo.htm
Tumescent Lipo www.plasticsurgery.org/surgery/tumes.htm
Abdominoplasty www.plasticsurgery.org/surgery/abdosurg.htm

TUMMY TUCK and MINI-TUMMY TUCK:
These surgeries can be combined with liposuction, or done alone, in the office ambulatory surgery center. In certain health circumstances, it is preferable to perform full tummy-tuck at the hospital, though fees are generally higher there.
See:
http://www.advanced-art.com/Post-Pregnancy-Lipo.htm
http://www.advanced-art.com/Mini-Tummy-Tuck.htm
http://www.advanced-art.com/Abdominoplasty.htm

TUMESCENT LIPOSUCTION:
The technique of Tumescent Liposuction has revolutionized the application of liposuction, by removing the problem of bleeding,
and thus preventing most bruising, post-op swelling, and thus pain. This allows more rapid return to activity, and generally
better results. More information is found on my WebPages.

CELLULITE:
Superficial fat pebbling (Cellulite) is generally not addressed by liposuction, but it is not worsened by it either. We have
available SilkLight Silhouette SubDermal Therapy for Cellulite, and improvement on the French Endermologie technique. (see:
http://www.advanced-art.com/Silhouette-SDT.htm )

CANDIDATES:
Generally candidates should be within about 20% of ideal body weight, since Liposuction is aimed at improving contours, and
not debulking fat which should be controlled by weight loss. The ideal candidate is healthy, exercises, is at about ideal body
weight, but has areas of protective storage fat that is resistant to dieting.
In many cases, heavier patients can also benefit, however.

OUT-OF-TOWN:
We see many patients from out of town for surgeries such as breast enlargement , or facial surgery. Liposuction and
Mini-Tummy Tuck can likewise be performed on out-of-towners, but presents some hurdles. We do not encourage far
out-of-towners to travel here for full tummy tuck, though, since the recovery may be more protracted, and may be better
accomplished closer to home (10-12 day stay, or commuting for follow-ups required). We try to tailor out-of-town patient consultations and surgeries to fall on consecutive days with most days available for surgery, excluding Monday. We do an early follow-up protocol, and try to limit the need for return to Richmond after surgery.
Since it is difficult for patients to describe in words what I will be seeing at the consultation, and since I need this data well in
advance of an out-of-town consultation in order to set up the right amount of surgery time, as well as to estimate the
approximate cost of surgery, I request that patients contact the office (804 - 290-0200) to talk to the staff about specifics of
their medical/surgical history. Also, I need data including (see questionnaire below)

age:
height:
weight:
areas of concern:
surgical history:
medical history:
medications:

Older patients will require pre-op medical exam and CBC blood test, and EKG, as appropriate. I also request a set of patient
photos (front, back, and both side views of the trunk and/or legs. A thong is a suitable modesty measure, as long as it does
not dig into the contours or cause distortion. This may make the difference between making a trip for surgery, versus deciding
against it for some patients, and so it's a good idea to know this in advance. We are currently working with some local hotels
to arrange favorable rates and transportation for the out-of towners, to make your stay as pleasant as possible. There are
ample activities available for visitors to Richmond, even those who are recuperating from surgery (Museums, etc.) Information
for out of town patients can be found on this page:
http://www.advanced-art.com/Guests.htm

LIPOSUCTION FEES:
Consultation for liposuction or tummy tuck: $50 (not applied to the surgery)
Charges vary by the size and number of areas to be addressed, but costs usually average:
Standard Abdomen: $1800-$2000; Large Abd: $2000-$2400
Hip/Flank areas: $1200-$1800
Outer Thighs: $1800-$2000
Inner thighs: $800-$1000
Knees: $600-$800
Submental/Neck: $1200-$2500 (depending on whether open defatting or muscle work is needed)
Pectoral (gynecomastia): $2500 or more (including open excision of glandular tissues if needed, but not including pathology
fees if any)

OR Fees: will vary with the number of areas to be addressed, and whether the procedure is done under local anesthesia, or under general at the time of another surgery.

TUMMY TUCK FEES:
Lipo of the stomach alone is about $2800, including OR, Mini-Tummy Tuck and Lipo of Abdomen is about $5300-$5700 under local with sedation, Mini-Tummy Tuck alone, including OR fee, is about $4500-$5000, and full Tummy Tuck with OR fee is about $6000-$7000, not including the anesthesiology fee (about $850). Most of these procedures are done in our ambulatory surgery center.

RECOVERY:
Tumescent Liposuction leads to rapid recovery for most patients. Many return to work within a couple days.
A compression girdle is supplied and must be worn for about 2 weeks, and then part time for a 3rd week. Exercise is
resumed within 2 weeks, but the swelling will persist for several weeks, and the final result takes 12 weeks or more to
manifest.
Minimal pain medicine is needed, and bruising is usually minor.
Mini-Tummy Tuck recovery is generally rapid, with resumption of full activity at 2 weeks, and light activity almost immediately.
Full Tummy-Tuck is a bit more ambitious, and requires both outpatient general anesthesia, and placement of rubber drains to
prevent fluid or blood buildup. Patients are able to resume light activity early, but no strenuous activity for about 2 weeks, and
no resumption of full exercise for 6-10 weeks.

Also, especially, check out the photo gallery at www.liposite.com . You will find many more of my photos, and some useful
data there, but you must be discerning and weigh some of the advice with "a grain of salt". Many of my active and future
patients post there from time to time.

I hope that this is enough info for starters. I see many patients from all over the country, and I hope that you will become one of
them!

PRE-OP QUESTIONAIRE:

]] SURGERY DATE:
]] NAME:
]] FULL ADDRESS:
    Street:
    Apt:
    City:                State:             Zip:
]] Phone Number(s) with Area code:
    Home: (      )
    Work: (       )
    Cell:    (       )
    Pager: (       )
]] Preferred Stable E-mail Address:
]] Age:
]] Date of Birth:
]] Social Security number (needed for OR posting):
]] Height:
]] Wt:
]] Current Bra size:      (for breast surgery patients only)

]] Do you sag with nipple at or below the level of the folds beneath your breasts?:
]] What size do you want to achieve?:

]] Do you smoke?                How much and how many years?
You will be urged to quit if you smoke, and will not be a candidate for
surgery if a major breast lift, facelift, or abdominoplasty is contemplated due the much higher
complication risk in smokers.

]] Do you have any medical conditions such as: Diabetes, high blood pressure,
or heart disease?

Are you presently under the ongoing care of a physician? Please elaborate:

Do you have a history of previous surgery? Procedures:

]] List any medications you take regularly and dosages and their reason (include aspirin,
vitamins, Birth control, homeopathics):

]] Are you allergic to any medicines?

]] How many pregnancies if any?

FOR BREAST SURGERY PATIENTS: (be sure to send photos from all angles)
]] Have you had any breast surgery in the past?               What?             Result
]] If you are planning to come for revision of an existing augmentation, when was it done?
Incision Site:                    Implants over or under the muscle:
What implant type (silicone or saline):                           Smooth or Textured:
Anatomical or Round:                            Implant Manufacturer:
Implant size:                                         Fill volume (for saline):
Can you obtain your old operative report(s):
Why do you want/need revision?:

]] Have you ever had a mammogram? Results:
If over 40 and you should have a mammogram within a year before surgery.
]] Is there a family history of breast cancer or breast disease?

FOR LIPOSUCTION AND TUMMY TUCK PATIENTS: (Be sure to send photos of all areas of concern from front, back and sides)
]]Which areas of concern do you think will benefit from liposuction?:
]]Have you had liposuction before?
}}Have you had any abdominal or leg surgery in the past?: What?:

FOR EYELID SURGERY PATIENTS:
]] An eye exam report, including a test for glaucoma and examination of the retina will be needed before surgery. You will need to forward a copy of this report (within the last year) before proceeding.

]]]]Please send these answers back to me, and I will save them for your file.

To cut data, use the cursor to highlight it with the left mouse key depressed, and click Ctrl-C. To paste it, place the cursor on the new document and click Ctrl-V. Answers can now be added to the pasted document.

PRE-OP REQUIREMENTS and RECOMMENDATIONS:
]] Some patients may require lab work or an EKG before surgery, this will need to be coordinated for patients from out of town, especially if they are having surgery in the Office Surgical Suite. Hospital patients will have these tests at the hospital, as warranted.
]] To limit risk of bruising and bleeding: No aspirin, ibuprofen (Advil;Motrin;Nuprin) or other arthritis pill, or any combination medicine (such as cold or flu pill) that contains them for 7 days pre-op.
Vitamin E and Vitamin C should be stopped for 3-4 weeks pre-op due to potential for increased bleeding and impairment of clotting.
]] Stop any homeopathic or herbal medicine (herbal teas; Ginseng, St.John's Wort) for at least 4 weeks pre-op, because they are unregulated regarding side effects, and many may impair clotting, or interfere with serum chemistry pre-op.
]] Do not drink alcohol for 24 hrs. pre-op
]] Do not shave axilla for 10 days (Breast augmentation patients only), or groin hair (lipo patients), until the AM of surgery to limit risk of ingrown hair.
]] Arrive for surgery with an empty stomach and nothing by mouth for 8hrs pre-op (except cardiac meds with a sip of water)
]] Wear a loose garment that buttons in front to the hospital or office the day of surgery (e.g. a sweat suit)
]] Do not wear jewelry to the hospital or office for surgery
]] If you are from out of town bring light snacks, saltines, baggies for ice chips, lifesavers or hard candy, mild soda (e.g. ginger ale) or juice to keep in your hotel room, along with books, or magazines.
]] Be sure that you are not pregnant (if applicable) pre-op. Honest- this happens!
]]For patients who take Birth Control Pills, you will be given an Rx for antibiotics to take after surgery, and be mindful that antibiotics may compromise the effectiveness of the contraceptives in your current cycle. Be sure to take appropriate precautions in this regard.
]] For BA patients, bring or send me photos of the "look" that pleases you, but remember, that the final result will be greatly related to the existing dimensions and shape of your chest and breasts, as well as height, weight, etc. This helps me to communicate what you consider to be a various cup size.
}} For Abdominal Liposuction or Tummy Tuck patients, extra care should be taken to clean the belly button with soap and water and a q-tip with each shower for a week before surgery.
]] Patients who smoke, should obviously quit smoking for several weeks ahead of time to prevent impairment of wound healing, and heightened discomfort associated with Nicotine, Carbon monoxide poison gas in smoke.

_______________________________________________________________________________________________________________________________

revised: October 29, 2007 04:12:10 PM