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Plastic Surgery/smartlipo- bra-line area

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QUESTION: Hi,

4 weeks ago I had smartlipo on my flanks, lower back and bra-line area. I have been wearing a compression garment almost 24 hours a day- except when showering and more recently when sleeping. I noticed afterward that there were no incision marks on my upper back or close to where my bra is but just assumed that the instrument was longer than I thought. But, the more I look at my body, see pictures online and compare the skin and sensation of the flank areas to my upper back, I'm fairly certain that it wasn't done on my upper back.

Can you tell me where one would need to make incisions in order to reach this area? I plan to talk to my doctor but would like to gather some information first. I suppose I'm worried they will tell me that it was done and not offer to either do that area or refund the money. The only incisions that I have on my back are on my lower back.

Thank you for any information you can provide!
Melissa

ANSWER: Hi Melissa,

I can't give you an absolute answer; there are many different length cannulas and it would be hard for me, or anyone else, to assert absolutely, that that area wasn't done.  However, I would suggest that you have an open and frank discussion with your surgeon, including a revision of specific areas (once you're adequately healed).  Revisions are not unheard of with liposuction in all its form, including SmartLipo.
I hope that this helps and good luck,
Dr. E

---------- FOLLOW-UP ----------

QUESTION: Hi! Thank you for your response!

I contacted my dr office and inquired about this and the response I got was that they only lasered my upper back (did not suction) in order to tighten the skin.

Is this common? Also, are there any instruments that are 2 feet long that are used?

They offered to give me part of the money back bc there was a miscommunication- which I am so grateful for- but the more I've thought about it, I still don't understand what actually happened. I'm asking you bc I feel like I've bothered them so much already.

I suppose my first issue is that the explanation doesn't really make much sense to me- lasering the area without suction. I never would have agreed to that. I want the whole thing or nothing at all. I also just checked my quote sheet which states:

Love handles (smart lipo) $2950
bra line (smart lipo) $1429
Left abdomen (cool sculpting) $650
Right ab (cool sculpting) $650

I was offered a discount if I paid and booked an appt by a certain date so in the end the entire smart lipo cost $3800 and the cool sculpting was $1100.

What confuses me is the quote (and what I paid for and understood) includes "smart lipo" of the bra line. Do people sometimes call something "smart lipo" when they only "laser" something but don't suction?

My concerns about this are that this laser-minus-suction practice was not mentioned or discussed with me; I didn't go in seeking my bra line done but when showing success pictures there was a woman with the sleekest, most beautiful back and I said "I want that!" and was told it utilized technology a step up from smart lipo. $1429 seems a lot to pay for something that produced no effect. According to them, there was miscommunication so they offered me half the money back- $700- which I am grateful for.

I still have a bad feeling that this isn't "right", though. My quote specifies "smart lipo" of the bra line area so unless that also refers to "lasering" too, it seems like they might not be misleading me. I don't want to believe that but I'd like to get more info.

Have you heard of this practice- using a laser under the skin but not suctioning anything out? what are benefits of this? Have you ever performed this procedure on the bra line area?

Ok, last question- SO SORRY to take up so much of your time! I promise to leave feeback =) I have 2 compression garments that are similar to leotards with the corset like clasps on the sides. The straps are thick and I would really like to purchase a few other compression garments that are easier to wear in the summer- but I want to buy the kind that are specifically for post lipo- made of the necessary material. Can you recommend a place I can find such things?

Thank you so very much for all your help!
Melissa

Answer
Hi Melissa,

Yikes!!  This is a long follow-up question with lots of info...but it's really too much for me to try to analyze and come up with a good answer for you.  But here's what I would urge you to do:

Decide whether or not you're basically happy with the surgery except for the area in question, or whether you're unhappy with the entire process.  If the first is the case, then talk to the surgeon about what can be done to improve that area.  I don't know if there is a two foot long probe (there may be) but, either way, if Cool Sculpting is an option, then that may be a very good choice for the back in the region of the bra-line which, in any event, is a difficult area to treat (the skin is thick, there is a lot of fibrous tissue and relatively less fat that one might hope).  That would be the simplest solution, and that's whether the area was under-treated, treated without enough success for what your expectations were or even unintentionally not treated.  Doctors are human and it's possible that the area you thought was going to be treated was not, as a result of a miscommunication.  Whatever the cause, perhaps it can be treated now.

If, however, you're unhappy with much or most of the treatment, then you and the surgeon have to reassess to see what can be done.  There are many possible explanations but, again, it's most helpful - primarily for you - if you and the surgeon can work together to find a way to give you a result you're happy with.

Again, hard for me to assess all of this, but that's the approach I would encourage you to take.

I hope that this helps and good luck,
Dr. E

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Alan M. Engler, MD, FACS

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Dr. Engler has answered over 6400 questions on social media sites, including over 3500 on AllExperts alone. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, lipomas, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), the Dr. Keith Ablow Show and Jerseylicious. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is www.bodysculpture.com. Follow Dr. Engler: @AlanEnglerMD

Experience

Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, as well as EyeScapes - Plastic Surgery of the Eyelids.

Education/Credentials
Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York in the Departments of both Surgery (Plastic Surgery) and Medicine (Dermatology), and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.

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