The tumescent technique. This involves even more fluid than is used in the super-wet technique. The surgeon will infuse three to six times as much fluid as the volume of the aspirate (fat, fluid and blood content) to be removed. Proponents say the tumescent technique swells the tissues, which aids in fat removal; but detractors say it interferes with the surgeon's ability to sculpt. Opponents also claim the technique is unsafe because of potential fluid overload and an overdose of anesthetic.

That’s because women tend to store more temporary fat in their bellies. “The fat stores are gained and lost,” says Lawrence Cheskin, MD, chair of the department of nutrition and food studies at George Mason University and director of the Johns Hopkins Weight Management Center. “By and large, belly fat comes off easier in the sense that it comes off first. That’s where a good amount of the fat is lost from.”

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 >
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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]

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.
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”).
The nerve impulse is characterised by a great influx of sodium ions through channels in the neuron's cell membrane followed by an efflux of potassium ions through other channels. The neuron is unable to fire again for a short time (known as the refractory period), which is mediated by another potassium channel. The flow through these ion channels is governed by a "gate" which is opened by either a voltage change or a chemical messenger known as a ligand (such as a neurotransmitter). These channels are another target for anticonvulsant drugs.[7]
The body doesn't react to all fats in the same way. Research correlates high intake of saturated fat (the kind in meat and dairy) to increased visceral fat, says Patton. On the other hand, monounsaturated fats (the kind in olive oil and avocados) and specific types of polyunsaturated fats (mainly omega-3s, found in walnuts, sunflower seeds, and fatty fish like salmon) have anti-inflammatory effects in the body, and if eaten in proper portions may do your body good. But Patton warns that eating too much fat of any kind increases your calorie intake and could lead to weight gain, so enjoy healthy fats in moderation. 
They found that any diet resulted in more weight loss than no diet at all after six months. Low-fat and low-carb diets were pretty much indistinguishable, with low-carb dieters losing 19 pounds (8.73 kilograms), on average, and low-fat dieters losing an average of 17.6 pounds (7.99 kg), both compared to non-dieters. At 12 months, the benefits showed signs of leveling off for both types of diets, with both low-fat and low-carb dieters reporting being 16 pounds (7.27 kg) lighter, on average, than non-dieters.
• 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

Nutrition: What is it and why is it important? Nutrition is the supply of materials that organisms and cells require to live. Humans need seven major types of nutrients to function. A nutritionist studies nutrients, how the body uses them, and the relationship between a person’s diet and their health. Here, learn more about nutrients and what a nutritionist does. Read now
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]
Stay motivated. Often times, people lose motivation to stick with a diet or an exercise routine. Finding a reason to stay motivated beyond belly fat goals, like overcoming a genetic predisposition to excess body weight or working toward fitting into your favorite article of clothing again, can help you stay motivated to meet your fitness and lifestyle goals.[40]
As of the moment, there is no industry standard as to how many calories should be consumed in a restricted ketogenic diet, but there are published studies that provide estimates. In one example, a 65-year-old woman who was suffering from glioblastoma multiforme (GBM), an aggressive type of brain cancer, was put into a restricted ketogenic diet that started with water fasting and then proceeded to consuming 600 calories a day only.

Dr. Josh Axe, DNM, DC, CNS, is a doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He’s the author of the books “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems,” “Essential Oils: Ancient Medicine” and the upcoming “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease” (February 2019, published by Little, Brown Spark). He’s a co-founder of Ancient Nutrition, a health company where the mission is to restore health, strength and vitality by providing history’s healthiest whole food nutrients to the modern world.


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]

Aside from carb flu, be warned that staying in long-term, continuous ketosis may have drawbacks that may actually undermine your health and longevity. To stay on the safe side, I recommend undergoing a cyclic ketogenic diet. The "metabolic magic" that ketosis brings to the mitochondria actually occurs during the refeeding phase, not during the starvation phase.
Body-jet liposuction. Using a thin, fan-shaped jet that pulsates water, your surgeon loosens fat cells from connective tissue while simultaneously vacuuming them out. It is sometimes called water-jet assisted liposuction or water-assisted liposuction. Other liposuction techniques destroy or break apart the fat cells before suctioning them out of the body, but the water-assisted technique may loosen them first. As a result, water-assisted liposuction may be less traumatic than traditional liposuction methods.

Artificial sweeteners like Splenda have been directly linked with the occurrence of diabetes and metabolic syndrome. Accumulating evidence suggests that frequent consumers of sugar substitutes containing aspartame, sucralose and saccharin may also be at an increased risk of excessive weight gain as well as development of metabolic syndrome, type 2 diabetes and cardiovascular disease. (4)
Essentially, the keto diet for beginners works by “tricking” the body into acting as if its fasting (while reaping intermittent fasting benefits), through a strict elimination of glucose that is found in carbohydrate foods. Today the standard keto diet goes by several different names, including the “low-carbohydrate” or “very-low-carbohydrate ketogenic diet”(LCKD or VLCKD for short).
When you call to schedule your procedure, we will request a deposit of 50% of the total cost of the procedure.  We only schedule one procedure per day, therefore if you cancel less than 2 weeks prior to your procedure 20% of your deposit is non-refundable.  If you cancel or reschedule your procedure less than 48 hours before your surgery, there will be no refund of your deposit.  
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.
During this procedure, Dr. Schlessinger will first mark the areas to be suctioned. At that time, you will then be taken to the state-certified ambulatory surgical center and a trained nurse will numb the areas to be treated. This will take about an hour or two, but during this time you will be able to watch TV or listen to music at your leisure. After this time, you will have a short time to relax and let the numbing take effect.
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.
Larger cannulae remove fat rapidly and there is a risk of removing too much fat and produce skin depressions and irregularities. An attempt to make a small change in the direction with a large canula results in a tendency to re-enter a pre-existing tunnel within the fat. This lack of precise control results in skin irregularities associated with the use of large cannulae. They are advocated only in those cases of LVL with access from sites from where the panniculus is to be sacrificed.
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]

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]
When lifestyle changes aren't enough, a child take prescription medicines to treat individual risk factors. So, kids with high blood pressure might be put on antihypertension drugs. Others with high LDL cholesterol might be prescribed statins or other lipid-lowering drugs. Children with high blood sugar, who are on the brink of developing diabetes, may get medicine to decrease insulin resistance.

Access incision sites are small and it is advisable not to close them with sutures to permit drainage of the excess wetting solution and serous exudate. Larger canullae require larger incisions, but these must be sutured loosely. A delayed drainage of the blood tinged tumescent solution produces prolonged swelling, bruising and pain after liposuction.


You can also lose inches in 30 days. "Just in my own 15 years of experience in working with patients, I have seen some lose up to five to 10 inches in a month from losing four to eight pounds," Jim told POPSUGAR. Keep in mind those five to 10 inches aren't just from your belly; those are full-body measurements from all major areas, including your waist, hips, chest, arms, legs, shoulders, and neck. He added that the inches lost depend on if you are weight training, what kind of cardio you're doing, how much water you're drinking, and how many calories you're eating.
Bhasin et al, as part of the Framingham Heart Study, found that sex hormone-binding globulin is independently associated with the risk of metabolic syndrome, whereas testosterone is not. Age, body mass index (BMI), and insulin sensitivity independently affect sex hormone-binding globulin and testosterone levels. [48] More recent studies have raised the possibility of an association between testosterone deficiency and metabolic syndrome. [49]

Arteries (are-te-rease): The blood vessels that carry oxygen-rich blood away from your heart for delivery to every part of your body. Arteries look like thin tubes or hoses. The walls are made of a tough outer layer, a middle layer of muscle and a smooth inner wall that helps blood flow easily. The muscle layer expands and contracts to help blood move.


In general, a person with metabolic syndrome is twice as likely to develop IHD and five times as likely to develop diabetes as someone without it. The probability of developing metabolic syndrome is also closely linked to a lack of physical activity and the fact of being overweight/obese. Other causes include insulin resistance, ethnicity (often Asian), family history, older age and other factors (Box 23.1). Associated diseases and signs may be raised uric acid levels, hepatic steatosis, haemochromatosis and acanthosis nigricans. Metabolic syndrome may be associated with inflammatory periodontal disease.
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. 
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.
Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.

A recent systemic review and meta-analysis of randomized controlled trials comparing the long-term effects (greater than 1 year) of dietary interventions on weight loss showed no sound evidence for recommending low-fat diets. In fact, low-carbohydrate diets led to significantly greater weight loss compared to low-fat interventions. It was observed that a carbohydrate-restricted diet is better than a low-fat diet for retaining an individual’s BMR. In other words, the quality of calories consumed may affect the number of calories burned. BMR dropped by more than 400 kcal/day on a low-fat diet when compared to a very low-carb diet.

Your most immediate and best option is to combine aerobic exercise and exercise involving lifting weights, as you will not only burn body fat but tone your muscles as well, positively changing your hip to waist ratio, and working quickly towards a healthier body in ever aspect. As you burn belly fat, you'll burn fat where it doesn't need to be elsewhere, too!


The concept of removing excess fat from localized body sites to achieve similar gains is credited to Charles Dujarrier, who in France,[2–4] attempted to remove subcutaneous fat using a uterine curette on calves and knees of a ballerina in 1921. An inadvertent injury of the femoral artery led to amputation of the dancer's leg. This unfortunate complication arrested further progress in this field and but it was a valiant attempt at the time.[5]
On a metabolic syndrome diet treatment plan, you should avoid fake and processed foods, artificial sweeteners, diet sodas, trans fats, refined carbohydrates and sugar, and alcohol. Foods to eat include fish and omega-3 foods, vegetables, fruits, legumes, and whole grains. In addition, the following supplements are beneficial for metabolic health: ginseng, berberine, bitter melon, holy basil, spirulina and maca root.
What causes high cholesterol? High cholesterol is a risk factor for heart attacks and coronary heart disease, because it builds up in the arteries, narrowing them. It does not usually have any symptoms, and many people do not know they have it. We look at healthy levels and ranges of cholesterol, at ways to prevent it, and medications to treat it. Read now

Excess fat is removed through tiny openings with a very small stainless steel cannula. The cannula is connected to a powerful suction pump and inserted through these openings. Because the cannulas are so small, there is virtually no discomfort, recovery time is lessened, and a better cosmetic result can be achieved. Additionally, Dr. Schlessinger has the finesse to get out just the right amount of fat so your results look good.
Recently, many of my patients have been asking about a ketogenic diet. Is a ketogenic diet safe? Would you recommend it? Despite the recent hype, a ketogenic diet is not something new. In medicine, we have been using it for almost 100 years to treat drug-resistant epilepsy, especially in children. In the 1970s, Dr. Atkins popularized his very-low-carbohydrate diet for weight loss that began with a very strict two-week ketogenic phase. Over the years, other fad diets incorporated a similar approach for weight loss.

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.


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.
Similar to vegetables, there are so many options that not only taste good, but help you ward off metabolic syndrome. You can opt for apples, bananas, oranges, pears or prunes if you need some ideas that are easy to consume quickly or on the go. In moderation (so you don’t overdo it on natural sugar), daily fruit consumption is an easy and therapeutic habit to develop if you haven’t already.
More definitive evidence that metabolic syndrome per se predisposes to coronary heart disease and cerebrovascular disease has been reported. Thus a twofold to fourfold increase in subsequent cardiovascular events has been described in men and women with metabolic syndrome (modified WHO criteria) even in the absence of type 2 diabetes or impaired glucose tolerance.234-236 Qualitatively, similar results have been obtained when metabolic syndrome was defined by ATP III criteria237,238 (Fig. 43-9). In a compilation of multiple studies, the presence of metabolic syndrome had a greater impact on the risk for developing diabetes (fivefold) than ASCVD (twofold).22,182,199 In addition, where studied, the rate of cardiovascular events was higher in patients who had diabetes and metabolic syndrome than in individuals with only metabolic syndrome.22,239
The amount of fat removed really depends on the size of the patient and their aesthetic goals. From a safety standpoint, the American Society of Plastic Surgeons recommends roughly 10 pounds of fat or less. Otherwise it is considered a high-volume liposuction, which does present an increased set of risks. It’s advised to get down to your ideal weight before undergoing a liposuction procedure.
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.
Following a ketogenic diet puts your body into a state of “ketosis,” which is a metabolic state that occurs when most of the body’s energy comes from ketone bodies in the blood, rather than from glucose from carbohydrate foods (like grains, all sources of sugar or fruit, for example). This is in contrast to a glycolytic state, where blood glucose (sugar) provides most of the body’s fuel (or energy).
Liposuction, also known as lipoplasty, is a commonly performed cosmetic plastic surgery procedure that can reduce the appearance of unsightly bulges and help you attain a slim, svelte physique. It is frequently performed on the abdomen, back and buttocks, but the technique can also be used on the thighs, knees, calves, upper arms, face, neck and other body areas.
Liposuction is generally used in an attempt to change the body's shape.[1] Weight loss from liposuction appears to be of a short term nature with little long term effect.[2] After a few months fat typically returns and redistributes.[2] Liposuction does not help obesity related metabolic disorders like insulin resistance.[3] It can also be used to remove excess fat in the chronic medical condition lymphedema.[8]
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 >
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.

The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]
There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement. A number of markers of systemic inflammation, including C-reactive protein, are often increased, as are fibrinogen, interleukin 6, tumor necrosis factor-alpha (TNF-α), and others. Some have pointed to a variety of causes, including increased uric acid levels caused by dietary fructose.[18][19][20]
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