Jeffery Klein, now at San Juan Capistrano, California, initially described the tumescent technique for lipo-aspirations in June of 1986 and the first article describing this technique was published in the January of 1987.[11] Ever since, Lipoaspirations and fluid managements have added a greater safety dimension. Ultrasonic liposuction was developed by Italian surgeon, Michael Zocchi[12] in 1996

Ultrasound-assisted liposuction (UAL) uses ultrasonic vibrations to turn fat cells into liquid. Afterward, the cells can be vacuumed out. UAL can be done in two ways, external (above the surface of the skin with a special emitter) or internal (below the surface of the skin with a small, heated cannula). This technique may help remove fat from dense, fiber-filled (fibrous) areas of the body such as the upper back or enlarged male breast tissue. UAL is often used together with the tumescent technique, in follow-up (secondary) procedures, or for greater precision. In general, this procedure takes longer than the super-wet technique.

Suction lipectomy was initially advocated for the treatment of localized collections of fat and for the removal of less than 1500 ml of fat material. However, many patients wish to have multiple areas treated or have diffuse collections of fat. In such instances, the removal of over 1500 ml of material and circumferential lipectomy are necessary to present optimal aesthetic results. However, when over 1500 ml of material is removed, anaesthetic requirements, fluid replacement, and treatment of blood loss become important if the procedure is to be performed safely.
The popular "flat belly diets"embrace much of the wisdom found in eating a Mediterranean diet, which helps everything from brain health to hearth health. The basic premise for both diets is eat foods rich in monosaturated fatty acids (MUFA) that may help reduce your belly fat storage. MUFA-rich foods include olive oil, nuts and seeds, avocodos, and fish. Eating yogurt regularly has also been found to be helpful in reducing belly fat.
Cannulae used today are extremely small, typically less than 6 mm, some are very small with an inside diameter of less than 0.6 mm. Blunt-tipped cannulae are standard as they decrease injury to blood vessels and reduce bleeding. The use of multiple side ports allows for efficient evacuation of fat. Manual systems consisting of syringes and canula tips have also been developed as some surgeons prefer the use of quiet and disposable instruments, they are more popular in small local aspirations of isolated fat bulges. They also became popular as a back-up system. Over time, aspiration units developed by manufacturers in consultation with surgeons have gradually become more powerful as well as quieter and allow for an efficient, pleasant surgical environment.
For many of Dr. Ayoub’s patients in Omaha, liposuction is the first surgical procedure they have ever undergone. So, it’s understandable that they would be nervous about having liposuction performed, despite their desire to lose their stubborn fatty deposits. When you work with us, though, you need not worry. Your safety and comfort are our top priorities, and we will do everything possible to make your liposuction procedure a pleasant experience.
• Cyclic ketogenic diet (CKD) — Whereas TKD is focused on fitness enthusiasts, CKD is focused more on athletes and bodybuilders. In CKD, you cycle between a normal ketogenic diet, and a short period of high carb consumption or "re-feeds."8 The idea here is to take advantage of the carbohydrates to replenish the glycogen lost from your muscles during athletic activity or working out.9
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.
Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!

A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]


A keto diet has shown to improve triglyceride levels and cholesterol levels most associated with arterial buildup. More specifically low-carb, high-fat diets show a dramatic increase in HDL and decrease in LDL particle concentration compared to low-fat diets.3A study in the long-term effects of a ketogenic diet shows a significant reduction in cholesterol levels, body weight, and blood glucose. Read more on keto and cholesterol >


Laser resurfacing involves directing concentrated pulsating beams of light at irregular skin. This procedure may be used to reduce wrinkles, blemished, or acne scars. There are two types of lasers commonly used in laser resurfacing: carbon dioxide and erbium. Treated areas heal in 10-21 days. Possible complications include milia, hyperpigmentation, and swelling.

When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common, but disappear within two weeks.[17] The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar, and handling illness.[19] The level of parental education and commitment required is higher than with medication.[44]


There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[54]
Add a cup of low-fat milk, a part-skim mozzarella stick, or a half cup of low-sodium cottage cheese to breakfast, and you may have a belly-busting win. While lots of research links calcium with lower body weights, results from a 2014 study suggest that calcium-containing foods may reduce waist circumference in those genetically predisposed to carrying weight in their midsection.
Metabolic syndrome, also known as Insulin Resistance Syndrome (IRS) and Syndrome X, is a cluster of metabolic and anthropometric traits including glucose intolerance, upper body fat distribution (increased intra-abdominal fat mass), hypertension, dysfibrinolysis, and a dyslipidemia (characterized by high triglycerides, low high-density lipoprotein [HDL] cholesterol, and small dense low-density lipoprotein [LDL] particles).1 Metabolic syndrome constitutes a powerful risk factor complex to identify individuals at increased risk for future Type 2 diabetes and cardiovascular disease (CVD). Insulin resistance and abdominal obesity are two central components of the syndrome and are integrally involved in its pathogenesis. Insulin resistance is a metabolic abnormality in which peripheral tissues exhibit a subnormal biologic response to the glucose-lowering action of insulin. Insulin resistance not only antedates the development of diabetes but is also a major metabolic defect (together with impaired insulin secretion and elevated hepatic glucose production) that maintains hyperglycemia in patients with overt disease. The central role of abdominal adiposity underscores the importance of body fat distribution regarding the metabolic consequences of obesity. Individuals with metabolic syndrome are also more prone to develop other pathologic conditions including polycystic ovary syndrome, non-alcoholic steatohepatitis (NASH), cholesterol gallstones, sleep disorders, and some types of cancer. Thus, metabolic syndrome is responsible for a tremendous burden of human disease and social costs, and nutritional therapy is key to both its prevention and limiting its progression to Type 2 diabetes and CVD.
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.

To get the most benefit from the Keto diet, you should stay physically active. You might need to take it easier during the early ketosis period, especially if you feel fatigued or lightheaded. Walking, running, doing aerobics, weightlifting, training with kettlebells or whatever workout you prefer will boost your energy further. You can find books and online resources on how to adapt Keto meals or snacks for athletic training.

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.
The short circuits in Zero Belly Diet offer a variety exercises that blast your core without relying on traditional sit-ups—easy enough to squeeze in before dinner in the comfort of your living room. Within six weeks of incorporating the mini circuits, test panelist Krista Powell lost 25 pounds—and she was finally able to dress in a way that reflected her true sense of style: “I’d avoided wearing high heels because the extra weight made my knees hurt so bad. I can actually wear my heels with confidence and without pain!”
Stephanie Pappas is a contributing writer for Live Science. She covers the world of human and animal behavior, as well as paleontology and other science topics. Stephanie has a Bachelor of Arts in psychology from the University of South Carolina and a graduate certificate in science communication from the University of California, Santa Cruz. She has ducked under a glacier in Switzerland and poked hot lava with a stick in Hawaii. Stephanie hails from East Tennessee, the global center for salamander diversity. Follow Stephanie on Google+.
About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether.[18] Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions.[46] This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure-free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.[9]
Liposuction is a surgery that removes fat and enhances the actual shape of the body. It does not address skin imperfections caused by sagging skin or cellulite under the skin. During your consultation, a discussion can be had regarding the available procedures, which address and improve skin texture. Some procedures recommended to correct skin laxity include abdominoplasty, thigh lift, neck lift, and butt lift surgeries.

I’m happy to say that aggressive and heart-healthy lifestyle changes are typically the main treatment for metabolic syndrome, which I fully support since lifestyle changes are the natural approach and get to the root causes of the disorder. Recommended lifestyle changes typically include heart-healthy eating, good stress management, losing and maintaining a healthy weight, more physical activity, and quitting smoking.

Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.


For the obese individual, a safe and limited surgical intervention that achieves even a minimally acceptable aesthetic contour of their profile in proportion to the body structure greatly enhances their self esteem. This is the prime indication and forms the essence of the much touted large volume liposuction. In most instances, the technique may be combined with a block dermolipectomy.
Fortunately, since peaking in 2001-2002, the overall prevalence of metabolic syndrome in the United States has fallen, primarily due to decreases in the prevalences of hypertriglyceridemia and hypertension—and in spite of increases in the prevalences of hyperglycemia and obesity/waist circumference. [27]  Data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) showed that the age-adjusted prevalence of metabolic syndrome had fallen to approximately 24% in men and 22% in women. [28]
Laser-assisted liposuction. This involves a small incision and the insertion of a laser fiber probe that produces a burst of energy to liquefy the fat before it is removed. (Two of the brand names you may have heard about are SmartLipo and CoolLipo.) Proponents say that laser liposuction is the latest and greatest and may also tighten skin. But detractors say it adds nothing to the results of liposuction except for expense.
In fact, once all our our reserved glucose/glycogen runs out after several days on a low-carb, keto diet, our bodies create compounds called ketone bodies (or ketones) from our own stored body fat, as well as from fats in our diet. In addition, researchers have discovered that ketones contain main benefits, such as fat loss, suppressing our appetites, boosting mental clarity and lowering the risk for a number of chronic diseases.
"The battle of the bulge." That tiny, five-word phrase has been shoved in our faces for years, thanks to television, newspapers and magazines. Sometimes, no matter how hard you fight, the bulge has a tougher army. The fact is that certain people have fat cells that will not shrink, despite diet and exercise. You can thank heredity for that in some cases.

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.
Drug treatment may be necessary to address other aspects of metabolic syndrome. Hypertension should be treated. Statins may be prescribed to treat unhealthy lipid levels. Some healthcare practitioners also recommend aspirin to decrease the risk of inappropriate blood clots. Some may prescribe medications to increase insulin sensitivity (although there is not widespread agreement on this).

A: There's no specific answer for this question, as it is dependent on many factors. However, you may be able to spot improvements right away. In a study that tested the ketogenic diet on obese people, researchers noted that after 24 weeks, the test subjects lost around 14 kilograms (30.8 pounds) of excess weight, going from an average 101.03 kilograms to 86.67 kilograms (222.7 pounds to 191 pounds).67
Your new figure will be similar to what you would expect if you could lose an equal amount of localized fat through diet and exercise alone. The use of smaller cannulas allows the fibrous connections between your skin and body to remain. These connections will contract over time. As a result, excessive skin folds are so rare that many patients avoid the necessity for surgical skin excision such as the tummy tuck by having excellent results with liposuction alone. Sometimes a small tuck can be done to improve skin after liposuction.
Metabolic syndrome is not merely a single disease but a collection of pathological conditions (i.e., abdominal obesity, insulin resistance, dyslipidemia, hyperglycemia, and hypertension) that increase the risk of developing diabetes and cardiovascular diseases. Low adiponectin levels directly correlate with the development of metabolic syndrome after adjusting for age, sex, and BMI [106,107]. In a study of Japanese adults, an increase in the number of metabolic syndrome components was associated with decreasing adiponectin levels [108]. Hypoadiponectinemia also appears to be a predictor for the future development of metabolic syndrome in obese individuals [109,110].

Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 
Eat more protein. Protein is required by the body to repair damaged cells and plays a vital role in growth and development.[3] But it can also play a role in weight loss. Diets high in protein tend to make people feel fuller, and when paired with a reduction in carbohydrate intake these diets can help with weight loss.[4] However, it's important to remember that not all sources of protein are good for you: red meat and full-fat dairy products, though high in protein, can also increase the risk of heart disease.[5] Good sources of protein include:[6]

The key sign of metabolic syndrome is central obesity, also known as visceral, male-pattern or apple-shaped adiposity. It is characterized by adipose tissue accumulation predominantly around the waist and trunk.[5] Other signs of metabolic syndrome include high blood pressure, decreased fasting serum HDL cholesterol, elevated fasting serum triglyceride level, impaired fasting glucose, insulin resistance, or prediabetes. Associated conditions include hyperuricemia; fatty liver (especially in concurrent obesity) progressing to nonalcoholic fatty liver disease; polycystic ovarian syndrome in women and erectile dysfunction in men; and acanthosis nigricans.


For reasons not entirely understood even today, fueling the body on primarily ketones reduces seizures. However, with the development of anti-seizure medications, few people with epilepsy rely on ketogenic diets today, according to a 2008 paper in the journal Current Treatment Options in Neurology, but some people who don't respond to medications can still benefit.
Spinal anaesthesia is preferred as bulk of fat to be sucked out is situated in lower half of the torso and the duration of surgery is about three hours. It reduces the drugs administered to the patient as general anaesthesia is avoided. A 27 gauge needle avoids the often troublesome post spinal anaesthesia headaches. Fentanyl is additionally added to the high spinal because it has a bupivacaine sparing effect on spinal anaesthesia. This covers the subcostal areas as well and further reduces the need of lignocaine in the infiltrating solution.

The Omaha Imagen Body Sculpting & Cosmetic Center specializes in the very latest liposuction body contouring techniques, including SmartLipo Laser Liposuction and Vaser Liposuction. We use the most advanced technology available for liposuction body sculpting. While there really is no "liposuction without surgery," our procedures minimize your downtime, getting you back to your busy lifestyle faster than you could after traditional liposuction or more invasive procedures, like a tummy tuck.
• Weight loss — If you're trying to lose weight, then a ketogenic diet is one of the best ways to do it, because it helps access your body fat so that it can be shed. Obese people in particular can benefit from this method. In one study, obese test subjects were given a low-carb ketogenic diet and a low-fat diet. After 24 weeks, researchers noted that the low-carb group lost more weight (9.4 kilograms or 20.7 pounds) compared to the low-fat group (4.8 kilograms or 10.5 pounds).1
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.
Three awesome essential oils for weight loss are grapefruit, cinnamon and ginger. Grapefruit essential oil actually works with your body in activating enzymes that help your body break down brown body fat. Cinnamon oil has been shown time and time again to help regulate blood glucose levels and something in your body called GTF, glucose tolerance factor. For that reason, cinnamon oil is also fantastic for anybody with diabetes. (19, 20)
Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.

Tight deadlines, bills, your kids—whatever your source of stress, having too much of it may make it harder for you to drop unwanted pounds, especially from your middle. And it's not just because you tend to reach for high-fat, high-calorie fare when you're stressed, though that's part of it. It's also due to the stress hormone cortisol, which may increase the amount of fat your body clings to and enlarge your fat cells. Higher levels of cortisol have been linked to more visceral fat.
That's why I co-wrote the "Fat for Fuel Ketogenic Cookbook" alongside renowned Australian celebrity chef Pete Evans. This book combines research-backed medical advice with delicious, kitchen-tested recipes that will help make shifting to fat-burning much easier. Whether you're just a budding cook or a master chef, there's a delicious meal waiting to be prepared that'll take your health to the next level.
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.
The short circuits in Zero Belly Diet offer a variety exercises that blast your core without relying on traditional sit-ups—easy enough to squeeze in before dinner in the comfort of your living room. Within six weeks of incorporating the mini circuits, test panelist Krista Powell lost 25 pounds—and she was finally able to dress in a way that reflected her true sense of style: “I’d avoided wearing high heels because the extra weight made my knees hurt so bad. I can actually wear my heels with confidence and without pain!”
Insulin resistance. Insulin is a hormone that helps your body use glucose -- a simple sugar made from the food you eat -- as energy. In people with insulin resistance, the insulin doesn't work as well, so your body keeps making more and more of it to cope with the rising level of glucose. Eventually, this can lead to diabetes. Insulin resistance is closely connected to having excess weight in the belly.
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