The media sometimes tells stories of liposuction patients who have endured bad results at the hands of inexperienced surgeons. Today’s liposuction techniques are much safer and more predictable than ever before, but surgeon skill still remains the number one factor when researching this procedure. The goal is to attain a natural and smooth result. An experienced surgeon will be able to provide this outcome.
The long-term results of liposuction depend on the preoperative condition of the patient's skin, the patient's overall health and expectations and the ability of the patient to maintain a healthy weight and lifestyle postoperatively. In difficult cases and for large volume liposuction, it is prudent to be wise and a staged or a combined procedure is safer for both the patient as well as the surgeon.
Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.[1][2][3]
Research shows that Western diet habits are a factor in development of metabolic syndrome, with high consumption of food that is not biochemically suited to humans.[21] Weight gain is associated with metabolic syndrome. Rather than total adiposity, the core clinical component of the syndrome is visceral and/or ectopic fat (i.e., fat in organs not designed for fat storage) whereas the principal metabolic abnormality is insulin resistance.[22] The continuous provision of energy via dietary carbohydrate, lipid, and protein fuels, unmatched by physical activity/energy demand creates a backlog of the products of mitochondrial oxidation, a process associated with progressive mitochondrial dysfunction and insulin resistance.

Among the most common undesirable outcomes of liposuction are 1) incomplete liposuction with very little evidence that liposuction was actually done, 2) excessive liposuction producing an unnatural or disfigured appearance, 3)irregular and uneven results with unsightly depressions in the skin, and 4) large scars that reveal that the patient has had liposuction. Caveat emptor (Buyer beware).


Inner knee, medial thigh or submandibular region [Figure 14] with a less dense fat are better managed with a standard wet technique rather than the UAL. Improved results with less fatigue in treating fibrous areas such as gynecomastia, posterior trunk, upper abdomen, posterior hip rolls and trochanteric regions [Figure 15] support the use of UAL as an adjunct to SAL rather than as an alternative.
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When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]

On the other hand, the types of foods you’ll avoid eating on the keto, low-carb food plan are likely the same ones you are, or previously were, accustomed to getting lots of your daily calories from before starting this way of eating. This includes items like fruit, processed foods or drinks high in sugar, those made with any grains or white/wheat flour, conventional dairy products, desserts, and many other high-carb foods (especially those that are sources of “empty calories”).

Blood pressure goals are generally set lower than 130/80. Some blood pressure medications offer more benefits than simply lowering blood pressure. For example, a class of blood pressure drugs called ACE inhibitors has been found to also reduce the levels of insulin resistance and actually deter the development of type 2 diabetes. This is an important consideration when discussing the choice blood pressure drugs in the metabolic syndrome.

Work your core. When many people think of core strengthening, they think of stomach crunches. Crunches are helpful for building abdominal muscles, but contrary to popular belief, crunches won't do much to lose the layer of fat stored in your belly, and can actually cause significant damage to the spine.[34] Instead, try a workout routine that strengthens your whole core, like yoga, or try abdominal presses and planking.[35]


In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.

You’ll see a noticeable difference in the shape of your body within 1 to 2 weeks after surgery. Once fat cells are gone, they should not return, but it’s important to note that liposuction does not get rid of all the fat cells in any given area. If you gain a lot of weight after procedure, the remaining fat cells can get bigger. By maintaining a healthy weight and exercising, your results should be long lasting.


The super-wet technique of fluid infiltration is used to maintain an almost bloodless aspirate. Compressive pressure garments are always worn in the immediate postoperative period to keep skin in close contact with underlying muscle and prevent any dead space. This helps to minimize postoperative bleeding, serous oozing, swelling and a third space shift of fluid.

^ Brunner EJ, Hemingway H, Walker BR, Page M, Clarke P, Juneja M, Shipley MJ, Kumari M, Andrew R, Seckl JR, Papadopoulos A, Checkley S, Rumley A, Lowe GD, Stansfeld SA, Marmot MG (November 2002). "Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study". Circulation. 106 (21): 2659–65. doi:10.1161/01.cir.0000038364.26310.bd. PMID 12438290.
There are currently no legal requirements for food manufacturers to label trans fats, according to the British Dietetic Association, so you need to check ingredients lists for hydrogenated fats and hydrogenated vegetable oils. The biggest culprits? Your ‘cheat day’ favourites: cakes, biscuits, ice cream, popcorn, pies, fried food, fast food, takeaways — the list goes on.
Although you won't be able to completely transform your body or even lose more than a few pounds in a month, you can jump-start your weight-loss journey and be well on your way to achieving your goals. Just be mindful that while you can lose weight in a month, you can't specifically target your belly; there's no such thing as being able to spot-reduce fat (your body decides where the fat comes from - yay, genetics!). We tapped registered dietitian and ACSM-certified personal trainer Jim White, who owns Jim White Fitness and Nutrition Studios and helps clients reach their weight-loss goals, for insight on how to lose belly fat in 30 days.
Keto diets, like most low carb diets, work through the elimination of glucose. Because most folks live on a high carb diet, our bodies normally run on glucose (or sugar) for energy. We cannot make glucose and only have about 24 hours’ worth stored in our muscle tissue and liver. Once glucose is no longer available from food sources, we begin to burn stored fat instead, or fat from our food.
Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.  The Merck Manual was first published in 1899 as a service to the community.  The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America.  Learn more about our commitment to Global Medical Knowledge.

Test panelist Bryan Wilson, a 29-year-old accountant, lost 19 pounds and an astounding 6 inches from his waist in just six weeks on the program, and he attributes his success to Zero Belly Smoothies. Their vegan protein will give you the same fat-burning, hunger-squelching, muscle-building benefits of whey, without the bloat. “I love the shakes. I added them to my diet, and almost immediately I lost the bloat,” Bryan said. “I’m a sweet craver, and the shakes were an awesome alternative to bowls and bowls of ice cream I would have had.”
The goal of metabolic syndrome treatment is to reduce the risk of heart disease and diabetes by controlling the associated problematic health conditions (high blood pressure, high cholesterol, diabetes, insulin resistance). “A study in which 53 percent of people had metabolic syndrome at the start found that over three years, intensive lifestyle changes—mainly diet and exercise—resulted in the lowest risk of developing diabetes and the lowest risk of developing metabolic syndrome in those who didn’t have it,” Ndumele says. Recommended changes include:

Your liposuction surgery may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite. Most lipoplasty procedures take ninety minutes or less to complete but may take longer depending on how much fat is removed and the number of liposuction sites. If multiple sites on both sides of the body are suctioned, the procedure could take over three hours.
Metabolic syndrome is thought to be caused by adipose tissue dysfunction and insulin resistance. Dysfunctional adipose tissue also plays an important role in the pathogenesis of obesity-related insulin resistance. [18] Both adipose cell enlargement and infiltration of macrophages into adipose tissue result in the release of proinflammatory cytokines and promote insulin resistance. [19]
The keto diet also appears to help induce autophagy, which helps clear damaged cells from the body, including senescent cells that serve no functional purpose but still linger inside tissues and organs. In animal studies when rats are put on the ketogenic diet, autophagic pathways are created that reduce brain injury during and after seizures. (21)
Metabolic syndrome (metabolic syndrome X, insulin resistance syndrome, dysmetabolic syndrome, hypertriglyceridaemic waist, obesity syndrome, Reaven syndrome) is the name for a group of risk factors that increase the risk for ischaemic heart disease (IHD), diabetes and stroke (Fig. 23.1). The metabolic syndrome is diagnosed when at least three of the IHD risk factors listed in Table 23.1 are present. Whether the syndrome, which affects possibly 25% of the US population, is a specific syndrome, and nothing more than the sum of its parts, is controversial.
The liver uses triglycerides, cholesterol, and protein to make triglyceride-rich very low-density lipoproteins (VLDL). In the blood, an enzyme removes triglycerides from VLDL to first produce intermediate density lipoproteins (IDL) and then low-density lipoproteins (LDL - the "bad" cholesterol). LDL is not all bad; it is an essential part of lipid metabolism and is necessary for the integrity of cell walls and for sex hormone and steroid production. However, in excess, LDL can oxidize and accumulate, eventually leading to fatty deposits in artery walls and to hardening and scarring of the blood vessels (and to cardiovascular disease and blood clots).

It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[23] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[18]

It may be quick and easy to pick up a delicious cheeseburger when you’re running late and have skipped lunch, but it can be a disaster for your diet and belly fat-burning plans. The amount of saturated fats, grease, and unwanted triglycerides found in fast food is precisely what you don’t want if you’re trying to burn visceral fat, so while it might be hard, cutting out fast food has to be near the top of your list. According to the experts at Johns Hopkins Medicine, if you want to lower fat intake, it is best to avoid fast foods and instead, include low-fat dairy products, lean cuts of meat and poultry, and ‘good’ fats like olive oil.


Insulin is a hormone that allows glucose to move into tissue cells, where is it is used for energy production. Insulin then prompts the liver to either store the remaining excess blood glucose as glycogen (for short-term energy storage) and/or to use it to produce fatty acids (which then become triglycerides). In people with insulin resistance, additional insulin must be released by the pancreas to overcome the tissue cells' resistance and allow glucose to enter the cells. This resistance and response to resistance can lead to increased insulin and glucose concentrations in the blood. Over time, increased glucose levels can harm blood vessels and organs such as the kidneys. Increased insulin levels can increase sodium retention by the kidneys, resulting in increases in blood pressure (which can lead to hypertension).


Look, the good doctor is right – he only forgot to stress “portion control” which is why many fanatical dieters are so kee-jerk reactive to any discussion – odds are you over ate like a hog before your keto diet, and are weak and insecure in your diet plans. Eat EVERYTHING in small amounts, and you will live long and prosper. The only thing to avoid are processed foods. Cook your meals from scratch using quality ingredients.
Differences between ketosis and ketoacidosis Ketosis and ketoacidosis both involve increased levels of ketones in the body. However, they are not the same thing. Nutritional ketosis is the aim of the ketogenic diet, and it is generally safe, whereas ketoacidosis is a complication of type 1 diabetes that can be life-threatening. Learn more here. Read now

Something that makes the keto diet different from other low-carb diets is that it does not “protein-load.” Protein is not as big a part of the keto diet as fat is. Reason being: In small amounts, the body can change protein to glucose, which means if you eat too much of it, especially while in the beginning stages, it will slow down your body’s transition into ketosis.
Your surgeon will then inject a wetting solution consisting of saline, epinephrine and a local anesthetic into the treatment areas. Saline is a mixture of salt and water that helps to soften up the fat for easier removal. Epinephrine constricts blood vessels to prevent bleeding, while local anesthetic helps to numb the area and increase your comfort.
The diet may not work for everyone but is suitable for many different seizure types and epilepsy syndromes, including myoclonic astatic epilepsy, Dravet syndrome, infantile spasms (West syndrome), and those with tuberous sclerosis. If you or your child has feeding problems, or has a condition where a high fat diet would cause problems, the diet may not be suitable.
Instead of satisfying your sweet tooth with some refined sugar, turn to berries and enjoy a slimmer waistline in no time. Berries are loaded with antioxidants, which can help reduce inflammation throughout the body, and research from the University of Michigan reveals that rats given a cherry-rich diet shaved off a significant proportion of their belly fat when compared to a control group. Berries like strawberries, raspberries, blueberries, and blackberries are also loaded with resveratrol, an antioxidant pigment that has been linked to reductions in belly fat and a reduced risk of dementia, to boot.
A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity published a guideline to harmonize the definition of the metabolic syndrome.[39] This definition recognizes that the risk associated with a particular waist measurement will differ in different populations. Whether it is better at this time to set the level at which risk starts to increase or at which there is already substantially increased risk will be up to local decision-making groups. However, for international comparisons and to facilitate the etiology, it is critical that a commonly agreed-upon set of criteria be used worldwide, with agreed-upon cut points for different ethnic groups and sexes. There are many people in the world of mixed ethnicity, and in those cases, pragmatic decisions will have to be made. Therefore, an international criterion of overweight (BMI≥25) may be more appropriate than ethnic specific criteria of abdominal obesity for an anthropometric component of this syndrome which results from an excess lipid storage in adipose tissue, skeletal muscle and liver.

The primary problem in metabolic syndrome is insulin resistance. In the body's attempt to compensate for insulin resistance, extra insulin is produced, leading to elevated insulin levels. The elevated insulin levels can lead, directly or indirectly, to the characteristic metabolic abnormalities seen in these patients. Frequently, the insulin resistance will progress to overt type 2 diabetes, which further increases the risk of cardiovascular complications.
Liposuction is performed under general anesthesia in an accredited surgical facility. It is considered an outpatient procedure. On average, each body part (i.e. tummy, thighs, etc.) will take approximately 30 minutes to complete. After surgery, patients will wear a compression garment on the treated areas. It takes about a full week for the bruising and swelling to dissipate, and can take several months for the final results to appear. Liposuction will produce scars where the cannula incision was made, but these are usually small and will fade over time.
An easy way to determine if you have too much belly fat is to measure yourself at home. Take a measuring tape and wrap it around your bare stomach, directly above your hip bone. The tape should be snug but not too tight. For women, a measurement of 35 inches or more indicates an unhealthy amount of belly fat. For men, a measurement of 40 inches or more indicates an unhealthy measure.

Chickpeas are naturally high in carbs — a single cup contains 45 grams of carbohydrates.31 However, you can modify the recipe to make it more nutritious. Try this recipe from Pete Evans, which replaces the chickpeas with beetroot.32 Beware, though, that beets have the highest sugar content of all vegetables, so consume them in very controlled amounts.
In my book "Fat for Fuel," I sought to educate readers about the benefits of using healthy fats as a catalyst to bring about improved mitochondrial function, thus allowing you to achieve better health. In essence, the book answers WHY it is important for you to consume healthy fats. However, you still need to know HOW to prepare the right ketogenic foods in an appetizing way.
Jim said people can healthily lose half a pound to two pounds a week. In a month, that could add up to four to eight pounds lost. Since one pound of fat equals 3,500 calories, to lose one pound a week, you would have to burn approximately 500 extra calories a day. This can be achieved through eating in a healthy calorie deficit or working out to burn extra calories (or a combination of both). Other lifestyle factors also play a role. Getting enough sleep will ensure your body recovers well and that you'll be energized for your workouts the next day. And too much stress increases the stress hormone cortisol, which can increase your cravings for caloric refined carbs and comfort food, which will prevent you from losing weight (especially in your belly). Make sure, in addition to eating in a calorie deficit, that you're also getting at least seven hours of sleep a night and managing your stress.
Tumescent liposuction is a dermatologist-developed fat removal procedure that is regarded as the safest and most successful method of liposuction. Unlike traditional liposuction, tumescent liposuction is a safer, less invasive procedure that allows for the permanent removal of unwanted fat. During the procedure, large volumes of sterile salt water, local anesthesia and dilute epinephrine are introduced to the area being treated. Once the anesthesia has taken effect, temporary swelling occurs, and fat can easily be removed through tiny cannulas no bigger than a sippy straw.
The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
In 1977 and 1978, Gerald B. Phillips developed the concept that risk factors for myocardial infarction concur to form a "constellation of abnormalities" (i.e., glucose intolerance, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia, and hypertension) associated not only with heart disease, but also with aging, obesity and other clinical states. He suggested there must be an underlying linking factor, the identification of which could lead to the prevention of cardiovascular disease; he hypothesized that this factor was sex hormones.[66][67]

When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits. 


I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?
The surgeons who perform liposuction must understand the physiology and differences between smaller volume and large volume liposuction. The anaesthesiologist is an integral member of the team and must have a complete understanding of the procedure and be well trained to handle preoperative, peri-operative, or post-operative problems of fluid shits and drug toxicity. The patient's core body temperature must be maintained using heating blanket systems on the table, minimizing body exposure and using warmed wetting solution.
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]
Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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