Super-wet technique is similar to tumescent liposuction. The difference is that not as much fluid is used during the surgery. The amount of fluid injected is equal to the amount of fat to be removed. This technique takes less time. But it often requires sedation (medicine that makes you drowsy) or general anesthesia (medicine that allows you to be asleep and pain-free).

Naturally sweet recipes in Zero Belly Diet were the key to test panelist Isabel Fiolek’s dramatic 13-pound weight loss. “I happen to have a big sugar addiction,” Isabel admits, “But the recipes have been surprisingly satisfying for my sweet tooth.” Isabel also made dramatic health strides: A checkup after her six weeks on Zero Belly Diet revealed she’d dropped her total cholesterol by 25 percent and her blood glucose level by 10 percent.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
• Reducing appetite — Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat. We’ve got quick keto diet chicken recipes to help.

Tumescence is the state of being ‘swollen and firm’ [Figure 2]. Tumescent liposuction uses large volumes of very dilute, hypotonic solutions of a vasoconstrictor agent that is gently injected into the subcutaneous fat and virtually eliminates surgical blood loss. It also permits the procedure to be done under regional anaesthesia with conscious sedation. Local anaesthesia may be supplemented for areas proximal to the level of the regional anaesthesia.
Because it lacks carbohydrates, a ketogenic diet is rich in proteins and fats. It typically includes plenty of meats, eggs, processed meats, sausages, cheeses, fish, nuts, butter, oils, seeds, and fibrous vegetables. Because it is so restrictive, it is really hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. Patients with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some patients may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.
The two main causes of metabolic syndrome are being overweight or obese and a lack of physical activity. A 2017 study highlighted that an hour of weekly resistance exercise was associated with 29 percent lower risk of developing metabolic syndrome, compared to no resistance exercising. Participants who coupled aerobic exercise with their resistance exercise showcased a 25 percent lower risk. (27) Metabolic syndrome is a metabolic disease that’s directly linked with insulin resistance, which is more common in obese and inactive people.
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.
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.

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.
Anyone with metabolic syndrome should make every attempt to reduce their body weight to within 20% of their "ideal" body weight (calculated for age and height), and to incorporate aerobic exercise (at least 20 minutes) into their daily lifestyle. With vigorous efforts to reduce weight and increase exercise, metabolic syndrome can be reversed, and the risk for cardiovascular complications can be substantially improved.
A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)
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.

Liposuction is a procedure to remove unwanted fat deposits from certain areas of the body. Common sites for liposuction include the face, neck, arms, back, hips, thighs, buttocks, and even the knee and ankle areas. Liposuction is best suited for patients who have tried weight reduction through good dietary habits and exercise and who continue to have localized fat deposits.


Regular follow-ups with the dietitian, and medical team, will monitor your or your child’s growth (height and weight, if applicable), health, their epilepsy, and if there is a need for any change to their anti-epileptic drugs (AEDs), such as changing to sugar-free versions. If the diet is followed carefully, individuals do not put on weight, or lose weight inappropriately.
Dr. Campos, it is unfortunate that you retain the medical community’s negative stance on the ketogenic diet, probably picked up in medical school when you studied ketoacidosis, in the midst of an obesity and type II diabetes epidemic that is growing every year, especially among populations who will never see the Harvard Health Letter. The medical community has failed in reversing this trend, especially among children, and the public is picking up the tab, in the form of higher health insurance premiums to treat chronic metabolic diseases which doctors cannot cure. The ketogenic diet does not bid its adherents to eat unhealthy processed meats, and the green leafy vegetables that it emphasizes are important in a number of nutritional deficiencies. People lose weight on the ketogenic diet, they lose their craving for sugar, they feel more satiety, they may become less depressed, their insulin receptors sensitivity is improved, and these are all the good outcomes you fail to mention. There is a growing body of research which demonstrates the neuroprotective effects of the ketogenic diet to slow cancer progression, as well as diseases like Parkinson’s and Alzheimer’s, for which there are no effective medical treatments. Please respect your patients by providing them with evidence-based medical outcomes, not opinions.
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[19] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[18]
Rapid growth and popularity of this procedure across continents happened when Illouz,[1,3,9] a Plastic Surgeon from Paris, France, began favouring the “wet technique” in which a solution of hypotonic vasoconstrictor saline and hyaluronidase was infiltrated into the adipose tissue prior to aspiration. He termed this as a ‘dissecting hydrotomy’ which facilitated removal of fat and reduce trauma with less bleeding.
Yes! It seems that after puberty, we do not create new fat cells. When you gain weight, you expand the fat cells that you have. Tumescent liposuction permanently removes fat cells to improve your body's contour. Should you gain weight after liposuction, it goes to the fat cells that remain in your body. The localized fatty deposits that existed prior to liposuction can no longer balloon up out of proportion to the surrounding areas.

This procedure has become one of the most commonly performed cosmetic procedures. At Aesthetic Surgical Images, you can rest assured that our entire staff of caring professionals will treat you with personalized attention. In your initial consultation, one of our plastic surgeons will discuss your goals, address any concerns and even help you visualize realistic results using a state-of-the-art computer imaging system. Learn more about this procedure by reviewing our list of Frequently Asked Questions.
In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate, and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]

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.


Limit foods high in refined carbohydrates and refined sugar (white bread, white pasta, white rice), and replace them with high fibre ‘complex carbs’ – think: whole grains, brown rice, sweet potato, oats, beans and pulses. Fill your boots with as many vegetables as possible – they’re low calorie, high in micronutrients, and the fibre in them will keep you full.
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
Team work, a judicious and an appropriate selection of a surgically and medically fit patient are essential factors resulting in an overall reduction in the duration of the surgery to within three hours [Figure 17]. When a large volume liposuction is planned for an obese patient, it is advisable to stage this procedure in 2 to 3 session. It is preferable to perform liposuction on either front of the torso in supine position or the back in prone position. This avoids the need to change the position, or turning the patient over, half way through the operation, thereby taking additional time. This also reduces the patients' exposure to the rigorous physiological demands of this procedure.
Also frequently seen with metabolic syndrome are tendencies for excessive blood clotting and inflammation. While obvious symptoms may be absent, these features are a warning of an increased likelihood of clogged arteries, heart disease, stroke, diabetes, kidney disease, and even premature death. If left untreated, complications from diseases associated with untreated metabolic syndrome can develop in as few as 15 years. Those who have metabolic syndrome and also smoke tend to have an even poorer prognosis.
If your procedure requires the removal of only a small amount of fat, the surgery may be done in an office setting. If a large amount of fat will be removed — or if you plan to have other procedures done at the same time — the surgery may take place in a hospital followed by an overnight stay. In either case, arrange for someone to drive you home and stay with you for at least the first night after the procedure.
Most of the bacteria that dwell in your gut are pretty useful. They produce hormones, regulate your immune system, digest food, extract nutrients, control your mood, manage your appetite, and much more besides. That obese people tend to have higher numbers of Firmicutes bacteria is no coincidence – according to research published in the online journal Nature, these bacteria increase the number of calories your body absorbs from food.
Mediterranean diet: Traditional cuisine of countries bordering the Mediterranean Sea, shown to reduce the risk for heart disease, diabetes, some cancers and dementia. On the menu: Plenty of fruits, vegetables and beans, along with olive oil, nuts, whole grains, seafood; moderate amounts of low-fat yogurt, low-fat cheese and poultry; small amounts of red meat and sweets; and wine, in moderation, with meals.
• Increasing muscle mass — Jeff Volek, Ph.D., is a registered dietitian specializing in how a high-fat, low-carb diet can affect health and athletic performance. He's written many scientific articles on this topic, as well as two books, and he explains that ketones have a similar structure to branched-chain amino acids that can be useful for building muscle mass. Ketones spare these amino acids, leaving higher levels of them around, which can help promote muscle mass.
Insulin (in-suh-lin): A hormone made by the cells in your pancreas. Insulin helps your body store the glucose (sugar) from your meals. If you have diabetes and your pancreas is unable to make enough of this hormone, you may be prescribed medicines to help your liver make more or make your muscles more sensitive to the available insulin. If these medicines are not enough, you may be prescribed insulin shots.
Cut back on calories. The most important part of losing weight is not working out until you collapse — it's your diet. If you burn 500 to 750 more calories than what you eat every day, you will lose 1–2 pounds every week (any more than that is considered unsafe weight loss). There are tons of little changes you can make to cut calories from your diet, from replacing high-calorie dressings with vinaigrette and asking for all dressings/sauces served on the side, eating at the table instead of in front of the tv, skipping cheese and other fatty additions to your salads and meals, using smaller plates, leave off the whipped cream on your coffee drink, and on and on.[2]

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I actually went on a ketogenic diet last year to see if it would help my migraines. I have a history of chronic migraines which would usually last 3 days, sometimes longer. Triptans help a lot but I don’t like having to take them. I stayed in ketosis for about 8 months and experienced a significant reduction in migraines, from feeling some type of headache (mild o r severe) almost everyday to 1 or 2x per month while in ketosis. Although I’m very healthy otherwise, I do think my migraines may have something to do with blood sugar fluctuations (despite previously eating a whole foods diet and no refined carbs), and keto totally stabilized this. I eventually came off of Keto because I’m not really a meat lover. When I came off, but remained low carb, my migraines stayed under control for the most part. When I increase carbs, they do return.
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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