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.


Ultrasonic-assisted liposuction is not a substitute for a healthy diet and regular exercise. Most patients who are good candidates for traditional liposuction are also good candidates for Ultrasonic liposuction, although the result may not necessarily be better. Patients who require a large amount of fat removal may have a better results with ultrasonic liposuction because of the possible enhanced skin retraction.
The total Liposuction cost of your procedure will depend on both the complexity of the procedure and the area or areas in which you desire treatment to achieve your goals. For example, the cost for a female to treat her love handles would cost less than a male who wants to have hi definition to his entire torso. It all depends on the results you want to achieve*. Complete options and cost will be discussed with you as part of your complimentary consultation.
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]
Excess abdominal fat leads to excess free fatty acids in the portal vein, increasing fat accumulation in the liver. Fat also accumulates in muscle cells. Insulin resistance develops, with hyperinsulinemia. Glucose metabolism is impaired, and dyslipidemias and hypertension develop. Serum uric acid levels are typically elevated (increasing risk of gout), and a prothrombotic state (with increased levels of fibrinogen and plasminogen activator inhibitor I) and an inflammatory state develop.

For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected.[44] Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.[9]
• Restricted ketogenic diet — As mentioned earlier, a ketogenic diet can be an effective weapon against cancer. To do this, you need to be on a restricted ketogenic diet. By restricting your carbohydrate and calorie intake, your body loses glycogen and starts producing ketones that your healthy cells can use as energy. Because cancer cells cannot use these ketones, they starve to death.12

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.


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.
Metabolic syndrome is defined as the presence of a cluster of risk factors that are associated with a significantly higher risk for cardiovascular disease in the general population. The definitions for metabolic syndrome from different expert groups are somewhat different but generally include measures of adiposity, dyslipidemia, hypertension, and abnormal fasting blood glucose levels. Insulin resistance is the dominant but not the only condition underlying the pathogenesis of metabolic syndrome. The different components of the metabolic syndrome are independent risk factors for the development and progression of chronic kidney disease (CKD); hence, patients with metabolic syndrome are significantly more likely to have CKD. Conversely, metabolic syndrome is highly prevalent in patients with ESRD, including among those undergoing maintenance dialysis.
Belly fat is excess abdominal fat surrounding the organs in your stomach. There are three types of fat: triglycerides (the fat that circulates in your blood), subcutaneous fat (the layer directly below the skin’s surface) and visceral fat (dangerous belly fat). Visceral fat is located beneath the muscles in your stomach and poses many dangers to your health when there is too much of it.

Pushing yourself past the normal “threshold” is a great way to burn belly fat. According to the World Health Organization, the U.S. Dept. of Health and Human Services, and other authorities, adults should undertake almost two and a half hours of moderate-to-vigorous physical activity each week to maintain good health. If you regularly work out, but hardly break a sweat and don’t feel “challenged”, then your body probably won’t respond by gearing up its metabolism and burning those visceral fat cells. However, surprising your body with varied workout styles and intensities, beyond what you normally do, can kick-start your system very quickly.
The primary problem in metabolic syndrome is insulin resistance. In the body's attempt to compensate for insulin resistance, extra insulin is produced, leading to elevated insulin levels. The elevated insulin levels can lead, directly or indirectly, to the characteristic metabolic abnormalities seen in these patients. Frequently, the insulin resistance will progress to overt type 2 diabetes, which further increases the risk of cardiovascular complications.
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]
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.
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]
Net carbs is simply total carbs minus fiber and non-digestible sugar alcohols, like erythritol. (This doesn’t apply to high glycemic sugar alcohols, like maltitol.) We don’t have to count fiber and certain sugar alcohols in net carbs, because they either don’t get broken down by our bodies, are not absorbed, or are absorbed but not metabolized. (Read more about sugar alcohols here.)

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.
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).
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[18] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] Some evidence indicates that adolescents and adults may also benefit from the diet.[9]
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.

If you’ve got weight to lose and you want it gone fast, try swapping out your usual proteins in favor of fish. Not only is fish lower in calories than an equivalent amount of beef or chicken, a study published in Obesity reveals study subjects who added omega-3 fatty acids, like those found in fish, to their diets shed more weight and had an easier time keeping it off than those who skipped them.
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]
If antioxidants are the good guys of gut health, trans fats are the supervillains. These sneaky fats actively contribute to your wobbly waist – not just by adding new fat, but by moving fat from other areas of your body to your belly. During a six-year study at Wake Forest University, monkeys that were fed an 8 per cent trans fat diet had 33 per cent more belly fat than monkeys that were fed an 8 per cent monounsaturated fat diet.
There are several medical studies — such as two conducted by the Department of Radiation Oncology at the Holden Comprehensive Cancer Center for the University of Iowa, and the National Institutes of Health’s National Institute of Neurological Disorders and Stroke, for example — that show the ketogenic diet is an effective treatment for cancer and other serious health problems. (12)
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If you're among the 30% of Americans who sleep less than six hours a night, here's one simple way to whittle your waistline: catch more Zs. A 16-year study of almost 70,000 women found that those who slept five hours or less a night were 30% more likely to gain 30 or more pounds than those who slept 7 hours. The National Institutes of Health suggest adults sleep seven to eight hours a night.
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[31]

In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
If you're among the 30% of Americans who sleep less than six hours a night, here's one simple way to whittle your waistline: catch more Zs. A 16-year study of almost 70,000 women found that those who slept five hours or less a night were 30% more likely to gain 30 or more pounds than those who slept 7 hours. The National Institutes of Health suggest adults sleep seven to eight hours a night.

Ultrasound-assisted liposuction (UAL): Also known as ultrasonic liposuction, the cannula is energized with ultrasound. This makes the fat melt away on contact. The ultrasound vibrations burst the walls of the fat cells. This emulsifies, or liquified, the fat, making it easier to suction out. This method is suitable for fibrous areas, such as the male breast, back, and in areas where liposuction has been done before.
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.
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.
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.
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.
[Guideline] Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol. 2009 Jan 20. 53(3):298-304. [Medline].
Cyclical ketogenic diet (CKD): If you find it difficult to stick to a very low-carb diet every day, especially for months on end, you might want to consider a carb-cycling diet instead. Carb cycling increases carbohydrate intake (and sometimes calories in general) only at the right time and in the right amounts, usually about 1–2 times per week (such as on weekends).
For weight loss, today's keto diets are the descendants of low-carb diets like the Atkins diet, which peaked in popularity in the early 2000s. Both types of diets reject carbs in favor of meatier meals. There is no single blueprint for the keto diet, but plans usually call for eating fewer than 50 grams of carbohydrates a day. (Wheat bread contains about 16 grams of carbohydrates per ounce, according to the USDA.) Celebrity adherents to the diet include Halle Berry and Kourtney Kardashian.
Eating slowly will also help cinch your waist, too. Inhaling croissants while run-walking to work will do little to satiate you – not that you’ll do much digesting anyway, with all that cortisol flooding your system. Instead, by making time to eat and focusing on your food (that also means not scrolling through Instagram), you’ll wind up eating less and you’ll feel fuller for longer.
Choose whole grains such as brown rice and whole-wheat bread instead of white rice and white bread. Whole-grain foods are rich in nutrients compared with more processed foods. Whole grains are higher in fiber, so the body absorbs them more slowly. They do not cause a rapid spike in insulin, which can trigger hunger and cravings. The 2015-2020 Dietary Guidelines from the USDA recommend that at least half of your grains be whole-grains.
Prediabetes: When blood glucose (also called blood sugar) levels are higher than normal and not yet high enough to be diagnosed with diabetes. That’s an A1C of 5.7 percent to 6.4 percent (a way to estimate your 3-month average blood sugar reading), a fasting blood glucose level of 100 to 125 mg/dl, or an OGTT (oral glucose tolerance test) two hour blood glucose of 140 to 199 mg/dl.
Jim said people can healthily lose half a pound to two pounds a week. In a month, that could add up to four to eight pounds lost. Since one pound of fat equals 3,500 calories, to lose one pound a week, you would have to burn approximately 500 extra calories a day. This can be achieved through eating in a healthy calorie deficit or working out to burn extra calories (or a combination of both). Other lifestyle factors also play a role. Getting enough sleep will ensure your body recovers well and that you'll be energized for your workouts the next day. And too much stress increases the stress hormone cortisol, which can increase your cravings for caloric refined carbs and comfort food, which will prevent you from losing weight (especially in your belly). Make sure, in addition to eating in a calorie deficit, that you're also getting at least seven hours of sleep a night and managing your stress.
Both techniques are good if performed by the right medical professional. Dr. Schlessinger performs both tumescent liposuction and SmartLipo using the laser. The issue is to choose a skilled surgeon to perform your procedure. It all comes down to experience. If your surgeon isn't skillful enough or doesn't have good judgment, you can end up having poor results whichever method is used.

Both techniques are good if performed by the right medical professional. Dr. Schlessinger performs both tumescent liposuction and SmartLipo using the laser. The issue is to choose a skilled surgeon to perform your procedure. It all comes down to experience. If your surgeon isn't skillful enough or doesn't have good judgment, you can end up having poor results whichever method is used.


Researchers believe that the ketogenic diet can also help patients with schizophrenia to normalize the pathophysiological processes that are causing symptoms like delusions, hallucinations, lack of restraint and unpredictable behavior. One study found that the keto diet lead to elevated concentrations of kynurenic acid (KYNA) in the hippocampus and striatum, which promotes neuroactive activity. Some studies even point to the elimination of gluten as a possible reason for improved symptoms, as researchers observed that patients with schizophrenia tended to eat more carbohydrates immediately before a psychotic episode. (19)

When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).


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.
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.
If you have very high blood sugar, then you might experience the signs and symptoms of diabetes like increased thirst, increased urination, fatigue and blurred vision. A normal fasting blood sugar level is less than 100 mg/dL. A fasting blood sugar level between 100–125 mg/dL is considered prediabetes. A fasting blood sugar level of 126 mg/dL or higher is considered diabetes. A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat high blood sugar) is considered a metabolic risk factor.
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals, and calcium-rich foods. In particular, the B vitamins, calcium, and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[18] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises three small meals and three small snacks:[28]

Plus, a 2015 study from the Annals of Internal Medicine showed that for those who have a hard time following a strict diet, simplifying the weight loss approach by just increasing fiber intake can still lead to weight loss. Women should aim for at least 25 grams of fiber per day (based on a 2,000-calorie) diet, according to the most recent U.S. Dietary Guidelines. Not sure where to start? Check out our step-by-step guide to increasing your fiber intake.
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.

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.

I have pancreatitis, well controlled, which is the way I want to keep it. The biggest difficulty I have with keto is this: I eat a small portion of steel cut oats in the morning. When I don’t, within two days , I start having bleeding, dark in colour. My endrocrinolagest feels that I need the roughage in the steel cut oats to replete the bowel lining. I have great difficulty loosing weight, always have, even though I eat very clean, no junk food, never eat out, don’t like pop, don’t crave sugar, cook all food fresh. Any comment? Willing to try anything you can suggest.


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.


Liposuction is a body sculpting procedure that uses a cannula, a thin tube with a vacuum, to break up and suction fat from specific areas of your body. Liposuction is a safe and time-tested procedure that Dr. Ayoub recommends for patients who want to reduce fat from problem areas that just won’t go away no matter how much they diet or exercise. Because the treatment targets specific areas of your body, incisions are small (2-4 millimeters), and patients in Omaha see immediate results that continuously improve during recovery.*
Tumescent liposuction has proven to be extremely safe even with the use of unprecedented large doses of the tumescent solution with dilute epinephrine, this produces intense widespread capillary constriction in the targeted fat, which in turn greatly delays the rate of absorption of the drug. This diluted epinephrine is absorbed into the bloodstream over 24 to 36 hours. This reduces peak concentration of the drug in the blood, which in turn reduces its potential receptor stimulant actions.
Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
Metabolic syndrome is similarly prevalent in men (24%) and women (22%), after adjusting for age. [28] However, several considerations are unique to women with metabolic syndrome, including pregnancy, use of oral contraceptives, and polycystic ovarian syndrome. [43] Metabolic syndrome and polycystic ovarian syndrome share the common feature of insulin resistance; they therefore share treatment implications as well. [44] Cardiometabolic risk is thought to be elevated in both groups. [45]
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