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.
Yes and no. Liposuction permanently removes fat cells, but it does not prevent future weight gain. However, if you do gain weight in the future, the fat cells will likely accumulate in a different area. Therefore, if you receive liposuction on your abdomen, you could retain a smaller waist for years to come, even if you gain weight on your arms, hips, or other areas.
Well, I am going to give this another try. I have great difficulty in eating greens , or drinking them, also I am not fond of fats, years and years of low fat diets have totally screwed my metabolism,and taste buds. I will read this page every day to keep my mind focused. Start tomorrow when I get up …… I work nights which can cause me problems as well. When I tried this diet before, I got terrible cramp, now I realise I wasn’t drinking enough water. Anyway.here goes.

The cannulae move parallel to the fat plane with the openings directed away from skin surface in a to and fro motion along the same path. The site is changed when the aspirate tends to become blood stained. Feathering of the peripheral areas is done once the basic earmarked areas have been symmetrically contoured bilaterally. The closure of these access incision sites is accomplished with interrupted loose sutures to permit easy drainage of fluid, reduce oedema and seroma.
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.
Liposuction of the entire thigh (circumferential liposuction) is not recommended due to an increase in swelling and lengthened recovery time. Rather, liposuction should be performed in a series of surgeries spaced about one month apart. Focusing the procedure on one specific area of the hips allows the lymphatic tissue to drain excess fluids quickly and evenly throughout the thigh, yielding more desirable results in a shorter amount of time. Liposuction of the thighs may be performed with thigh lift surgery.
Most people who have metabolic syndrome have insulin resistance. The body makes insulin to move glucose (sugar) into cells for use as energy. Obesity, commonly found in people with metabolic syndrome, makes it more difficult for cells in the body to respond to insulin. If the body can’t make enough insulin to override the resistance, the blood sugar level increases, causing type 2 diabetes. Metabolic syndrome may be a start of the development of type 2 diabetes.
The concept of liposuction surgery may seem simple, but, as with any type of surgery, the process is actually quite complex. A skilled physician will be well trained in all aspects of the liposuction procedure, and will be able to explain the process to you in as much detail as you wish. Of course, each procedure can vary significantly, depending on the treatment area and the type of liposuction you select. However, most procedures follow the same basic outline:
What is more concerning is that the areas where the liposuction was performed will not gain fat, but other areas will, creating the appearance of an apple core. Dr. Schlessinger always encourages his patients to prepare for a healthy life after liposuction and make sure they are fully committed before undergoing this expensive and important procedure.
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]
There are many ways to do liposuction, for example liposuction can be accomplished painlessly either totally by local anesthesia or with general anesthesia. In the realm of liposuction, maximum speed and maximum volume of aspirate are not criteria for excellence. Ultimately, excellence is measured in terms of patient happiness which is a function of safety, patient comfort, finesse, and quality of results.
If a man's breasts are enlarged with glandular tissue, liposuction is not an option and other hormonal or medication therapies should be pursued. If the breasts are asymmetrical or oddly shaped, the patient should be examined for possible tumors prior to any surgical intervention. A mammogram is the most effective method for detecting tumors and the possible presence of male breast cancer. After proper testing, a physician can help a patient determine the best course of action.
Eating mindfully. A child who learns to see food as fuel and not emotional compensation can start to make better choices at mealtime — for example, selecting complex carbs instead of simple carbs (whole-grain instead of white bread, brown rice instead of white); getting more fiber with beans, fruits, and vegetables; choosing "healthy" fats like olive oil and nuts; and avoiding too many empty calories from soda and sweets.
Patients should be aware that, when liposuction is combined with other procedures, their risks for post-surgical complications will be a bit higher. Some doctors will space the procedures out to avoid these potential effects. Others may suggest removing less fat when liposuction is combined with other treatments. Although a few surgeons do not advise combining multiple procedures, most will do so, simply using extra precautions to protect their patients' safety. Although recovery time will be longer when procedures are combined, patients will only have one recovery rather than two separate procedures and two separate periods of downtime.

Physiological saline was used in the place of RL previously. The author has noted an appreciable reduction in the tissue swelling post operatively after shifting to RL solution in place of conventional normal saline. The hypotonic saline solution results and Ringer Lactate results were identical and hence the current method of Infiltration fluid does not have any hypotonic saline fluid. The intense local vasoconstriction reduces blood loss to insignificant amounts for most procedures [Figure 8].

If you want to achieve a sleeker figure, but you are reluctant to undergo surgery, there are a number of non-invasive techniques that may prove effective. Although these alternatives do not typically provide the same dramatic effects that liposuction can give, they can still be excellent choices, especially if you are not a candidate for surgical fat removal.
Pre-tunnelling (Mladick)[25] increases instrument control as, without suction, it creates desired superficial as well as deep planes of fat removal. It prevents an inadvertent removal in the sub-dermal fat layer that can result in contour irregularities. Similarly, cross tunnelling with at least two port sites at right angles are used to treat an area of adiposity. The use of multiple port sites provides for better contouring and feathering of edges.

^ Brunner EJ, Hemingway H, Walker BR, Page M, Clarke P, Juneja M, Shipley MJ, Kumari M, Andrew R, Seckl JR, Papadopoulos A, Checkley S, Rumley A, Lowe GD, Stansfeld SA, Marmot MG (November 2002). "Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study". Circulation. 106 (21): 2659–65. doi:10.1161/01.cir.0000038364.26310.bd. PMID 12438290.
The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]
It’s scary but true that most of the disorders associated with metabolic syndrome are symptomless. However, one very common visible sign of metabolic syndrome is a large waist circumference: at least 40 inches for men and 35 inches for women. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. (26)
Body lifts: Body lifts are more comprehensive treatments designed to target the abdomen, thighs, and buttocks at the same time. During this procedure, a doctor will create circumferential incisions, running along the groin, thighs, hips, and waist. In addition to tightening damaged muscles, he or she may use liposuction to remove fat from one or more of these regions.
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]

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]


Tumescent liposuction. During this technique, the surgeon will inject a solution is injected into your fatty areas before the fat is removed. It is made up of a saline solution, a mild painkiller and epinephrine, a drug that contracts your blood vessels. The solution not only helps the surgeon removed the fat more easily but it helps reduce blood loss and provides pain relief during and after surgery.
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.
The surgeon's training. Dr. Schlessinger is a board-certified dermatologist and board-certified cosmetic dermatologic surgeon in Omaha, Nebraska who is well trained in the procedure by the dermatologist who invented this special type of liposuction and has performed thousands of these cases with expertise. His laser credentials are sterling as well, having introduced laser resurfacing to Omaha and the United States in 1994, while introducing laser hair removal to Omaha and the United States in 1997, having performed the FDA qualifying trials for this now universal procedure. Additionally, he was the only investigator in the U.S. who was invited to participate in 3 new Botox competitor product trials.

The keto diet was originally designed not for weight loss, but for epilepsy. In the 1920s, doctors realized that keeping their patients on low-carb diets forced their bodies to use fat as the first-line source of fuel, instead of the usual glucose. When only fat is available for the body to burn, the body converts the fats into fatty acids, and then into compounds called ketones, which can be taken up and used to fuel the body's cells.
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.
In the post operative period following abdominal liposuction, the patients are advised to avoid prolonged sitting for 3 to 4 weeks to prevent development of skin folds and creases. Pressure garments are to be religiously worn for 3 to 6 months. While, a regular finger tip pressure massage in the indurated areas is fine with small areas of induration, an ultrasound massage works well for lumpy areas and sites with persistent pain or edema.
Dr. Schlessinger will then do the SmartLipo part if you are doing that procedure in addition to the tumescent liposuction. This part takes about 30 minutes, and then Dr. Schlessinger will proceed to perform the tumescent liposuction part, which involves suctioning the additional fat. This part takes about 45 minutes. Then you will be taken to the recovery room to relax and eat the lunch of your choice prior to being discharged to a friend or family member, who will take you home to rest for the remainder of the day.
Eating avocados in particular has been found to be clinically associated with lower metabolic syndrome in U.S. adults because avocado benefits your gut. (11) Think of a rainbow as you make your daily vegetable choices (red bell peppers to pumpkin to yellow squash to arugula to purple eggplant). This way, not only do you keep your meals interesting, but you obtain all of the great vitamins and nutrients vegetables can offer you!
Overweight individuals with metabolic syndrome, insulin resistance, and type 2 diabetes are likely to see improvements in the clinical markers of disease risk with a well-formulated very-low-carbohydrate diet. Glucose control improves due to less glucose introduction and improved insulin sensitivity. In addition to reducing weight, especially truncal obesity and insulin resistance, low-carb diets also may help improve blood pressure, blood glucose regulation, triglycerides, and HDL cholesterol levels. However, LDL cholesterol may increase on this diet.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
Most people who have metabolic syndrome have insulin resistance. The body makes insulin to move glucose (sugar) into cells for use as energy. Obesity, commonly found in people with metabolic syndrome, makes it more difficult for cells in the body to respond to insulin. If the body can’t make enough insulin to override the resistance, the blood sugar level increases, causing type 2 diabetes. Metabolic syndrome may be a start of the development of type 2 diabetes.
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).
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

Abdominal Etching: This specialized form of liposuction is designed to enhance the abdominal muscles and give patients a desirable set of "six-pack abs." The surgeon will first outline the muscles and then the thin layer of fat that can obscure these muscles. He or she may use traditional, ultrasound, or laser assisted techniques to perform this minimal recovery treatment.


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]
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.
PAL uses an up and down, vibrating like motion of the cannula to acquire greater fat removal. When compared to simple suction-assisted liposuction, PAL requires less energy for the surgeon to operate while also resulting in greater fat removal. It is commonly used for difficult, secondary, scarred areas, and when harvesting large volumes of fat for transfers to other areas.[11]
In 1977 and 1978, Gerald B. Phillips developed the concept that risk factors for myocardial infarction concur to form a "constellation of abnormalities" (i.e., glucose intolerance, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia, and hypertension) associated not only with heart disease, but also with aging, obesity and other clinical states. He suggested there must be an underlying linking factor, the identification of which could lead to the prevention of cardiovascular disease; he hypothesized that this factor was sex hormones.[66][67]

Technically, any licensed doctor can perform liposuction, but not all doctors offer the same degree of expertise. For example, you would not want a podiatrist performing your cosmetic procedure. For your safety and ultimate satisfaction, you should always choose a physician who is certified by the American Board of Plastic Surgery. To receive this certification, a doctor must have had three to five years of medical training with two to three of them focused on cosmetic surgery. Additionally, doctors must pursue ongoing education to maintain their certification.


A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
Pierre Fournier[8] of Paris France, improvised on the Fischer's' liposculpture technique and was the initial advocate of the ‘dry technique’ in which no fluids were infiltrated prior to liposuction. He went on to become an authority in liposuction and fat transplantation and later promoted the benefits of tumescent anaesthesia. He was instrumental in technology transfer to the next generation of surgeons representing varied specialties all over the world.
“For some people, it’s knowing, ‘Typically I eat a whole sandwich,’” says Gagliardi. “‘Now, I’m going to make the decision to eat half a sandwich at lunch and save the other half for my dinner and essentially cut my calories in half. And they feel good about that. They’re not having to do math.” To get started, check out these 25 simple ways to cut 500 calories a day.

Patients should be aware that, when liposuction is combined with other procedures, their risks for post-surgical complications will be a bit higher. Some doctors will space the procedures out to avoid these potential effects. Others may suggest removing less fat when liposuction is combined with other treatments. Although a few surgeons do not advise combining multiple procedures, most will do so, simply using extra precautions to protect their patients' safety. Although recovery time will be longer when procedures are combined, patients will only have one recovery rather than two separate procedures and two separate periods of downtime.
In order to transition and remain in this state, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
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.
Achieving ketosis is a pretty straightforward, but it can seem complicated and confusing with all of the information out there.4If you want to learn more about ketosis and the scientific process around it, you can visit a very in-depth discussion about on Dr. Peter Attia’s website. Here’s the bottom line on what you need to do, ordered in levels of importance:
Your liposuction surgery may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite. Most lipoplasty procedures take ninety minutes or less to complete but may take longer depending on how much fat is removed and the number of liposuction sites. If multiple sites on both sides of the body are suctioned, the procedure could take over three hours.
I am trying to get back into keto. I did it before and I was so happy when I lost 10lbs (I did the keto for a month). I am ready to go back to this lifestyle. All this information is very helpful, I have written it all down so it can be easier for me to remember what is allowed and what is not. Looking forward to get back on this keto journey. Thank you for all the great info.
The most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.
Immediately after liposuction, the patient will see some of the results of their surgery. Usually, up to 10 pounds of fat can be removed, resulting in a noticeably more pleasing body contour. Liposuction can remove stubborn fat deposits from small areas for an aesthetic improvement, but should not be expected to dramatically alter your overall weight.

The Mediterranean diet is palatable and easily sustained. In addition, recent studies have shown that when compared to a low fat diet, people on the Mediterranean diet have a greater decrease in body weight, and also had greater improvements in blood pressure, cholesterol levels, and other markers of heart disease -- all of which are important in evaluating and treating metabolic syndrome.
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