Advent of the tumescent technique in 1987 has allowed for safe contouring in ambulatory single session liposuction under regional or general anaesthesia. Safety and aesthetic issues define MegaLiposuction to be in Volume in litres of more than 10% of Body weight in Kgs. 870 cases of liposuction were performed between September 2000 and August 2008. In (65%) cases, the total volume of aspirate was greater then 5 liters. (Range: 5 to 25 liters). In 24% cases, the large volume liposuction was combined with a limited or a total block lipectomy. Regional anaesthesia with conscious sedation was preferred except where liposuction was for above the subcostal region (the Upper Trunk, Lateral Chest, Back, Gynaecomastia, Breast, Arms and Face) or when the patient so desired. Tumescent infiltration with Lactated ringer, adrenalin, triamcinalone and hyalase was made in all cases. This approach has clinically shown less tissue edema in the post operative period than when the conventional physiological saline was being used in place of Ringer Lactate. The amount injected varied from 1,000 ml to 12,500 ml depending on the size, site and area. Local anesthetic was included only to the terminal portion of the tumescent mixture while infiltrating the sub-costal regions, or when above costal region was combined with below costal region being anaesthetized with Spinal Anaesthesia. The aspirate was restricted to the unstained white / yellow fat and the amount of fat aspirated did not have any bearing to the amount of solution infiltrated. There was no major complication. Blood transfusion was given only on one occasion when the patient had been on aspirin and had also received Low Molecular weight Heparin intra-operative. The hospital stay ranged from 8 to 24 hours for liposuction as well as for liposuction with a lipectomy. Serous discharge from access sites, sero-sanguinous fluid accumulation requiring drainage were necessitated in less than 10% cases. Minor re-contouring touch ups were requested in 5% cases. Early ambulation was encouraged for mobilization of third space fluid shifts to expedite recovery and to prevent deep vein thrombosis. More than 10% patients were operated on for Liposuction of other areas, after a gap of 7 days to 6 months. Meticulous perioperative monitoring of systemic functions ensures safety in tumescent megaliposuction for the obese and rewarding results can be achieved in a single sitting.

Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
Limit alcohol intake is key to metabolic syndrome and good health in general. Too much alcohol can raise your blood pressure and triglyceride levels. Alcohol also adds extra calories to your diet, which can cause weight gain. However, limited consumption of alcohol can actually be good for you, as a meta-analysis published in Clinical Nutrition found that while heavy alcohol consumption indeed increases the risk of metabolic syndrome, “very light alcohol consumption seemed to be associated with a reduced risk of metabolic syndrome.” (9)
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]
My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.
The low glycaemic index treatment (LGIT)[49] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[18] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
Lose fat with high-intensity interval training (HIIT). If you're trying to lose weight fast, HIIT training can super-charge your metabolism for upwards of 24 hours after exercising.[27] This means your body will continue burning calories long after you've ended your workout. HIIT burns more calories in less time than steady-state cardio. In one study, researchers looked at two groups, one running for 30 to 60 minutes three times per week, the other doing four to six 30-second treadmill sprints, resting for four to six minutes between each sprint. After six weeks, it was found that the group doing HIIT training lost more weight.[28]
Doing crunches until the cows come home? Stop it! When you're down to your final inches of belly fat, the dreaded crunch won't be the exercise that finally reveals your six-pack. "You can't spot reduce," Jill says. Instead, she suggests doing functional exercises that use the muscles in your core—abdominals, back, pelvic, obliques—as well as other body parts. "These exercises use more muscles, so there is a higher rate of calorie burn while you are doing them," she says. Planks are her favorite functional exercise—they activate not just your core muscles but also your arm, leg, and butt muscles.
Sometimes, to whip your body into shape, you have to get a little nutty. While nuts are high in fat, it’s that very fat that makes them such powerful weapons in the war against a ballooning belly. In fact, a study published in Diabetes Care revealed that study participants who consumed a diet rich in monounsaturated fats, like those in nuts, over a 28-day period gained less belly fat than their saturated fat-consuming counterparts while improving their insulin sensitivity.
Results can vary. Tumescent liposuction, just the same as regular liposuction, involves suctioning of fat from areas where excess accumulation has occurred. Whether this procedure will have short-term results or long-term results depends entirely on how you diet afterward. Dr. Schlessinger has seen many patients who never again need any help in the areas treated, while others who had poor habits after the surgery needed extra procedures within a year or so. Whatever the case, it is unlikely that the same amount of fat will re-accumulate in the exact same areas.

When your cortisol levels are through the roof, it triggers the release of insulin, and this is where things go awry. Initially, the ‘fight-or-flight’ response shuts down your digestive system so you can deal with the “threat”, like a very hungry lion or, more realistically, heavy traffic on your way to work. Once the danger has passed, your body seeks to replenish the hundreds of calories you burned fighting to the death/swearing at rush hour traffic and makes you ravenously hungry.

Basically, carbohydrates are the primary source of energy production in body tissues. When the body is deprived of carbohydrates due to reducing intake to less than 50g per day, insulin secretion is significantly reduced and the body enters a catabolic state. Glycogen stores deplete, forcing the body to go through certain metabolic changes. Two metabolic processes come into action when there is low carbohydrate availability in body tissues: gluconeogenesis and ketogenesis.[4][5]

First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?
Another win for your morning cup of joe: Caffeinated coffee keeps things moving through the digestive tract. Since staying regular is key to a tighter-looking tummy, drinking about 8 to 16 ounces of java at the same time every day can help you stay on schedule. Remember: Sugary drinks can lead to weight gain, so skip fancy flavorings and synthetic sweeteners containing sugar alcohols, which can cause bloating.
The patient is prepared circumferentially in the torso and the lower extremity as these can be treated without repeated pepping and repositioning. The patient's skin is painted with 5/10 percent Povidone Iodine solution while he/she stands next to a sterile draped operating table. Upon completion of the skin preparation, the patient lies on the table and is sedated or is given regional or general anaesthesia as required.
Since diet sodas contain artificial sweeteners as well as other unhealthy ingredients, you don’t want to touch these lethal soft drinks. Studies show that the consumption of diet soda is associated with significantly greater risks of select incident metabolic syndrome components and type 2 diabetes. According to one 2009 study, daily consumption of diet soda was associated with a 36 percent greater risk of metabolic syndrome and a 67 percent greater risk of having type 2 diabetes! (5)
This is a wealth of information. My husband and I are starting the keto diet tomorrow and I knew nothing about it. When I sat down to look up information about it, I found this. Thank you! This is everything I need to know in one place. We are not as healthy as we’d like to be and I am optimistic this will help us obtain our goals, along with an exercise plan.
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
Liposuction for fat removal is similar to Phaco-emulsification of the ocular lens for cataracts. It permits elimination of localized fat deposits through miniature incisions that leave an inconspicuous scar. Principal indications are fat deposits in the gluteo-crural areas, hips and the abdomen. While the ideal body shape is trim and athletic, a well contoured shoulder and chest, a flat abdomen and a narrow hip and thigh area are sought-after and lipo-sculpturing is anticipated to bestow these expectations.
The metabolic syndrome quintuples the risk of type 2 diabetes mellitus. Type 2 diabetes is considered a complication of metabolic syndrome. In people with impaired glucose tolerance or impaired fasting glucose, presence of metabolic syndrome doubles the risk of developing type 2 diabetes.[28] It is likely that prediabetes and metabolic syndrome denote the same disorder, defining it by the different sets of biological markers.
Every effort is made to ensure that all our information is correct and up to date. However, Epilepsy Society is unable to provide a medical opinion on specific cases. Responses to enquiries contain information relating to the general principles of investigation and management of epilepsy. Answers are not, and should not be assumed to be, direct medical advice and is not intended to be a substitute for medical guidance from your own doctors. Epilepsy Society and any third party cannot be held responsible for any actions taken as a result of using this service. Any references made to other organisations does not imply any endorsement by Epilepsy Society.
Why is the keto diet good for you? A keto diet is one that prioritizes fats and proteins over carbohydrates. It can help reduce body weight, acne, and the risk of cancer. Find out about the mechanisms through which it achieves these benefits and the research that supports it. This MNT Knowledge Center article also discusses the risks of the diet. Read now
You will need to wear a snug elastic dressing, girdle, or body stocking over the treated area to aid healing. These are provided free of charge for patients at Skin Specialists. Dr. Schlessinger purchases these garments from the inventor of the tumescent technique, Dr. Jeffry Klein, because they are the best garments possible. Some patients prefer to have a second pair on hand, and this extra pair may be purchased for a small extra charge if so desired at the time of surgery.
The best way to prevent metabolic syndrom is to adopt heart-healthy lifestyle changes. Make sure to schedule routine doctor visits to keep track of your cholesterol, blood pressure, and blood sugar levels. Speak with your doctor about a blood test called a lipoprotein panel, which shows your levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
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