Episode 6: The Latest on Liposuction: Body Contouring Surgery Update with Dr. Simeon Wall, Jr.

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Is Lipo for you? Is it affordable? Dr. Wall is known throughout the country as one of the modern pioneers of body contouring surgery. Teri, our host of BeautyNow invites Dr. Wall onto the show to talk about how Lipo can transform and sculpt your body. Teri trusts Dr. Wall and has known him for years so she'll cover all the issues around Liposuction in a well-balanced interview. You'll hear how Laser Lipo compares to traditional Lipo as well as a full discussion covering Smart Lipo, Arm Lipo, Neck Lipo, Tummy Lipo and more. Laser Liposuction is a new technique that breaks up the membranes of the adipose cells, transforming them into an oily substance that is absorbed and eliminated by the body. Teri Struck gets all the latest info on what works and uncovers all the gimmicks as the ultimate champion of her listeners. Find out how much can you really lose and what kind of men and women make the best candidates for this surgery. Learn where you can go to find an accredited doctor near you and what questions to ask to determine which medical professional is the right fit for your needs. Teri also explores the downside of lipo including the perennial question, "does the fat come back somewhere else?" This in-depth discussion, made great by the miracle of podcasting, clears up the rumors and delivers the facts. Tune into Beauty Now with Teri Struck so you can hear for yourself what lipo can do for you from our Lipo expert. Dr. Simeon Wall. Dr. Wall’s father and partner in practice was one of the first people in the country to perform liposuction (in 1982) and one of the founding members of the Lipoplasty Society of North America. His excellent results and 20 years of experience in liposuction attract patients from all over the country. Dr. Wall has traveled all over the world teaching his techniques in body contouring and was recently voted by his peers as one of the Best Doctors in America.

Transcript

The Latest on Liposuction: Body Contouring Surgery Update with Dr. Simeon Wall, Jr.

Announcer: This program is brought to you by http://www.personallifemedia.com.

[Intro Music]

Teri Struck: Hi I’m Teri Struck, your weekly host for Beauty Now.  Please tune into our show at http://www.personallifemedia.com to hear the latest on lasers, lashes, cellulite, hormone replacement, hair extensions, lash extensions, lifts, amazing breasts, injectibles and what’s new. 

Dr. Simeon Wall:: What I like to do is tell everybody who comes in for body contouring how to get their best results.  It’s really for the person who is in pretty good shape but might have some spots that have always been trouble spots. 

Teri Struck: When I think that it is unrealistic for women or men, because I know a lot of men get it today, to think that they’re going to go back to eating Cheetos to get rid of their fat when they just got it all lipo-sucked.

Dr. Simeon Wall: Right, well one of the things I say sometimes when people ask that, I will say sometimes well you can eat a lot faster than I can suck. 

Teri Struck: [laughs]. 

Teri Struck: Today we’re lucky to have Dr. Simeon Wall, a board certified plastic surgeon in Louisiana whose specialties are too many to list.  He is going to tell us everything we can get to know about liposuction.  Welcome Dr. Wall!

Dr. Simeon Wall: Thank you very much for having me. 

Teri Struck: Thank you so much for agreeing to talk to us.  I know you’re really busy and have a huge practice.  I have a few questions for our listeners about liposuction.  First of all, who are the best candidates for lipo? 

Dr. Simeon Wall:  Well for liposuction I think most people do recognize that the best candidates are people who are within 50% of their ideal body weight.  If you go off those charts for someone who is around 5’5” and 125 pounds plus say another 15 or so pounds which would put someone around 135 pounds, that would put someone at the average height and weight of women in America.  These are the people that have the best results because they are closest to their ideal body weight.

Teri Struck: Right.  So they take care of themselves in general but they have those spots.

Dr. Simeon Wall: Exactly. That is exactly right.  It’s really for the person who is in pretty good shape but might have some spots that have always been trouble spots, that have always been the last places to go when they have dieted before.  They will get skinny everywhere else, their face will get gaunt, their arms will get skinny, their legs may get skinny or other areas but the spots that really bother them like around the trunk, the tummy, the flanks, the hips or maybe the thighs, those are the ones that are the last to go.  Those are the people who are absolutely the best candidates for liposuction.

Teri Struck: What about if you are a larger patient.  You know, they come in.  They’ve lost 30 or 40 pounds, they just want to get inspiration.  What do you say to them?

Dr. Simeon Wall: What I like to do is tell everybody who comes in to see me for body contouring, how to get their best result.  I will start with trying to tell them, ok for you your best result will be at your ideal body weight, short of that within 15% of your ideal body weight and then short of that let’s talk about where we can do some improvements and we will stand in front of the mirror and I will try to show people the areas where we could expect some improvement and if it’s everywhere then we will have to target some areas.  For example, if we want to try and widdle the waist down on someone who is a little bit overweight, that will really help them.  They know they are not going to be skinny just from the liposuction procedure, but we are going to make a dramatic change in the shape. 

Teri Struck:  So people have to be realistic.  I mean they are going to come in and they are going to lose some but they are not going to look like Pam Anderson. 

Dr. Simeon Wall: Right.  Unless they are very, very thin to begin with and they just have little trouble spots, which I do have those patients, but the vast majority of people are people who are maybe just a little bit higher than they want to be and they have some really resistant spots and they have dieted and exercised but there are just too many fat cells in those specific spots.  For a female the typical spots are around the waist, the hips and also the thighs where there is just genetically more of a pre-disposition to have fat deposition and there are more fat cells there. 

Teri Struck: So, you just said something that everybody asks me about fat cells.  So if you suck up those fat cells, does it come back in other places. 

Dr. Simeon Wall:  Well no.  You know, we get that question all the time, everyday!  There are a lot of misconceptions about what liposuction does.  Think of it like this, let’s just pick someone’s leg and in the thigh, on the lateral thigh where the saddlebags are, you’ve got a big lump of fat, but everywhere else the leg looks great.  Well, there is fat throughout that entire leg. 

Teri Struck: Right.  Which tons of women have that saddlebag.

Dr. Simeon Wall: Right, and throughout the leg and in the calf, everywhere there is fat but there are way more fat cells in that saddlebag.  So consequently if you gain any weight, each of those fat cells are going to grow.  Since there are already more fat cells in that spot, that is going to grow quicker and even if you lose a little bit of weight, they’re going to go down but there are so many more fat cells that it won’t be as obvious.  So what liposuction does is it redistributes that, it will take out those extra fat cells so you’ve got just one layer of fat cells in one area, and one layer of fat cells in the other areas of the leg so when you gain and lose weight now you gain it proportionally throughout everywhere.  So you gain it everywhere in the leg or you lose it everywhere in the leg.  Does that make sense?

Teri Struck: It totally makes sense, but then do you supply all those kind of rules with the patient, you tell them they need to diet and all that and keep healthy. 

Dr. Simeon Wall: Do they have to diet after liposuction?

Teri Struck: Well, not diet but to stay healthy, stay fit.

Dr. Simeon Wall: Oh absolutely!

Teri Struck: I mean, I think that it is unrealistic for women or men, I know a lot of men get it today, to think that they are going to go back to eating Cheetos to get rid of their fat when they just got it all lipo-sucked.

Dr. Simeon Wall: Well, one of the things that I say when people ask that, I will respond with, well you can eat a lot faster than I can suck. 

Teri Struck: [laughs]

Dr. Simeon Wall: So, as much fat as we can suck out, you can’t suck it all out.

Teri Struck: Right.

Dr. Simeon Wall: You’re always going to have fat cells, even in those areas, so you can still get fat.  The human body has the capacity to get to 1,500 pounds.  We’ve seen horror stories of people getting that big, so fat cells can get really big. 

Teri Struck: That would be a whole another show.  That would be the what? What is it called? Gastric bypass show?

Dr. Simeon Wall: Right. 

Teri Struck: So, and that would be body lifts, right?

Dr. Simeon Wall: Right.

Teri Struck: That is another question then.  So people lose all this weight and have sagging skin in their tummy and they expect to get it lipo’d but sometimes they need to get it tucked. 

Dr. Simeon Wall: Right.  Well, and that is where actually talking to the plastic surgeon actually comes in handy.

Teri Struck: Right. 

Dr. Simeon Wall: You have to figure out whether it is a problem with too much fat or too much skin.

Teri Struck: For a consultation then?

Dr. Simeon Wall: Sometimes it is both!

Teri Struck: Right.

Dr. Simeon Wall: Frequently, the way I do my tummy tucks and body contouring, I like to really widdle the waist down, make it really small. So when I do an abdominoplasty or what is normally called a “tummy tuck”, I tighten up the muscles and I take off the extra skin but I also liposuction all of the fat around that area at the same time because frequently it is a combination. 

Teri Struck: I hear about tightening up the muscles, how do you do that?

Dr. Simeon Wall: Well, it sounds kind of bad, but we lift all the skin up.  The skin and all the fat layer goes up and we are looking right at those muscles, those six-pack muscles that everybody sees, we are looking at those but frequently with women who have had children, those muscles will spread apart in the centre.

Teri Struck: Right.

Dr. Simeon Wall:  So we just go in there with some very heavy sutures and pull them back together so that the separation, the thinner sometimes it can be 6 inches wide, 10 inches, 12 inches wide where they have just really separated out.  Even women who are in really good shape, they still have that pooch.  

Teri Struck: Yaay, that sounds great! [laughs]

Dr. Simeon Wall: Yeah, bring it right back in the middle and it flattens back perfectly back to even before they had kids.

Teri Struck: We’re lucky to live in the time of this. 

Dr. Simeon Wall: Oh, it’s great. 

Teri Struck: So can you explain for us, what is the difference between tumescent laser, ultrasonic, there are so many different terms out there today we are all confused.

Dr. Simeon Wall: Types of liposuction.  Sure.  Remember we were talking about taking out fat.  So there are lots of different ways to either take it out or get rid of it.  Starting with some injections.  A lot of people talk about mesotherapy, and that is a certain type of chemical.  The active ingredient is this oxycholic acid that reacts with the fat cells, it basically kills the fat cells and consequently makes it smaller.  So there are some chemicals that can be injected that hurt or kill the fat cells to make it a little bit smaller.  Then we get rid of them by sucking them out, and that is where we are talking about standard liposuction, which for most people means tumescent liposuction and that just means that we add a lot of fluid in around those fat cells to make them easier to suck out and also to minimize any bleeding.  Then after the theatre liposuction, there are people that talk about power-assisted liposuction and ultrasonic-assisted liposuction and now laser-assisted liposuction.  Really the way to think about that is they are all ways to potentially get the fat out easier and smoother because one of the biggest problems with liposuction is that the fat can be taken out but it can be taken out unevenly leaving you with an uneven look or a divot or a shark bite or just some type of contour deformity and we really want to make sure that it is as smooth as possible so it looks very natural. 

Teri Struck: What is your favorite technique?

Dr. Simeon Wall: A huge portion of my practice is liposuction and repeat liposuction patients.  Our practice has been here for 37 years and my father is my partner.  He was one of the first five guys in the county doing liposuction back in 1981. 

Teri Struck: And your wife as well. She is also in the hobby. 

Dr. Simeon Wall: That’s right.  My father and my wife, we’re all in practice together.  Consequently I get these people who have had liposuction, two, three, four and even five times over the years from other places or from my father and nobody really wants to deal with those people and somehow I get stuck with them and somehow I like dealing with them.

Teri Struck: Well I know you’re brilliant and a lot of people go to you. 

Dr. Simeon Wall: Well I don’t know about that.  Maybe I’m the stupid one.

Teri Struck: No, no you were valedictorian.  I read up on you. [laughs]. 

Dr. Simeon Wall: [laughs] Right.  Well I guess with these patients, it depends a lot on whether they are a first-time liposuction patient or a repeat liposuction patient.  The first time people, I love to use the power-assisted liposuction device and I have developed some cannulas that make it very easy with the power-assisted to take the fat out very smoothly and get down to a very thin layer of fat and still have everything look very good.  I also use ultrasonic-assisted liposuction.  There are a couple of different ultrasonic liposuction devices.  The one I use is the newer Lasonic device which is a post-ultrasound.  Basically what that one does, it is just a high-frequency sound that explodes the fat cell and it emulsifies the fat, turns it into butter basically so that it can be sucked out very easily and gently. 

Teri Struck: That sounds pretty tempting to go to a restaurant and then just come visit you.  We are going to have to take a break but I want to hear much more about this, and I think you are inspiring a lot of people to want to do something about those saddlebags.  So we’re going to thank our sponsors, including http://www.personallifemedia.com and we’ll take a break and we will be right back with you. 

[Sponsor Advertising]

Teri Stuck: Hi, we’re back talking with Dr. Simeon Wall out of Louisiana and he is answering all of our questions about liposuction.  This is so interesting.  I have another question.  Tell me about removal of cellulite with liposuction.

Dr. Simeon Wall:  well, unfortunately I would love to tell you that liposuction will improve cellulite or take it away but that’s just not the case. 

Teri Struck: You’re an honest guy.  Does it improve it?

Dr. Simeon Wall: It can.  What I tell my patients is, we do liposuction to make that area smaller and to remove the fat and make the entire shape be smaller.  We’re not doing it to make the cellulite or the ripples in the skin better.  Now that being said, can liposuction improve cellulite? Yes but I caution my patients not to expect it.  If it does happen, it’s a bonus, but don’t expect it’s going to make the cellulite better because it’s just not designed for that and it’s not realistic to think that it is going to improve the cellulite in everybody.  I don’t even promise my patients that it is going to improve the cellulite. 

Teri Struck: And that actually touches on a really good subject that is about being realistic.  I have talked to so many people that, in my eyes they look so much better but in their eyes they don’t.  I’m sure you experience that in your practice.  How do you deal with that?

Dr. Simeon Wall: Well I think that talking to people a lot ahead of time, which I try to do and showing them hundreds of other patient’s before and after pictures, specifically before and after pictures that match their body type, I think that really helps to get people in the frame of mind of what to expect.  So many people are like, I have no idea what to expect from this surgery.  Well, you come into this office and you see 30 other people who have a body just like yours, who had the identical procedure you are thinking about having and you get to see how they look afterwards, that is really going to give you a good idea.

Teri Struck: Right. 

Dr. Simeon Wall: And if they think those after pictures look good, then I’m pretty sure they are going to respond pretty well to the surgery.  If they think that these people do not look very good well then I know, hey this is my work, if this isn’t going to make you happy then you’re probably not going to be happy with the surgery that you get. 

Teri Struck: Right, exactly.  They have to be happy within themselves too.

Dr. Simeon Wall: Right. 

Teri Struck: So for all the listeners out there that would have a hard time affording liposuction from people like you, what would you advise?  You have financing companies.

Dr. Simeon Wall: Well of course diet and exercise is always the mainstay of trying to look better. 

Teri Struck: Right.

Dr. Simeon Wall: But there are some things that are on the horizon that may not be as expensive.

Teri Struck: Costly. 

Dr. Simeon Wall: Let’s talk about a couple of those.

Teri Struck: Ok. 

Dr. Simeon Wall: For instance, I talked about the mesotherapy which are some chemicals that can be injected in very quickly, simply but the problem is there is not enough data out there to show that it really does work or that it really does last long term and I tend not to use my patients at guinea pigs.

Teri Struck: Right. 

Dr. Simeon Wall: and we’ve also seen some problems with patients who have had mesotherapy and I have seen some patients who have had problems with mesotherapy.  So I’m not sold on that, but it is promising. 

Teri Struck: Right.

Dr. Simeon Wall: Something that is very, very interesting is Hyphoo, which is high-density focused ultrasound and there are two new companies that have some devices that actually have been shown to work.  These are external ultrasound devices.   Basically the person lays down on the table and a little hand piece comes out and this theme of high intensity sound is focused deep into their tissues, into the fat and it emulsifies the fat just like the internal ultrasound that we used today.

Teri Struck: Wow!  Can I get a home device?  [laughs]

Dr. Simeon Wall: [laughs] No.  Then the body will just absorb that extra fat so it’s not going to be as dramatic as actually sucking out a lot of the fat. 

Teri Struck: Right.

Dr. Simeon Wall: After several treatments, or even just a couple, you can get a very noticeable result and I have seen some initial results with these devices and they are very, very interesting and these are things that can be done at just 30 minutes or an hour in the office without having any incisions or any surgery and really not much down time at all.

Teri Struck: That sounds so promising.  Well you know it’s been in the news recently, People Magazine, it’s everywhere is Smart Lipo. Do you know about that and can you tell us about that? 

Dr. Simeon Wall:  Well, the smart lipo is an internal device, which works off of a laser.  It’s a Yag laser that the easiest way to think of it is, we’ve all heard of lasers we use, for instance on laser resurfacing on the face where there is a laser beam that goes and heats up an area of the skin and it can tighten up things or kill some cells to cause retraction of the skin or tightening of the skin.  Well they’ve taken this Yag laser and they’ve put it in a very very small little tube that you can insert inside and it basically does the same thing.  It takes a fat cell and it makes the fat cell to where it’s leaky.  The fat cell leaks out some of it’s contents, sometimes it can even kill the fat cell and sometimes not. 

Teri Struck: That sounds a little scary, it doesn’t sound as good as just getting regular lipo and going for it. 

Dr. Simeon Wall: No, it’s not nearly as- if you don’t suck out that fat you’re depending once again on the body to absorb that extra fat so you’re not going to get 5 liters of fat out of somebody with that device unless you actually suck it out whereas I can go in and in a couple hours, you know what a 2 liter Coke bottle looks like, I can suck out 2-3 of those in just 2-3 hours and make a massive change immediately, but with the Smart Liposuction device, I don’t know if it would be possible to remove anywhere near that amount, especially if you’re not sucking it out and you’re depending on the body to get rid of that fat.  So I think it probably works okay, just on a much smaller scale.

Teri Struck: Right, so if you do go in and suck all those Coke bottles of fat, how much down time is there?

Dr. Simeon Wall: In that case where we are doing a liposuction of all the way around the waist and the hips and perhaps all the way around the legs and the thighs, the people are usually sore, my patients are usually sore for a few days, like the worst work out they’ve ever had for about 3-5 days, but of course they are walking the night of surgery, the day of surgery, the next day, they usually only need pain pills for a couple of days and then they are pretty much back into their normal routine within 5-7 days. 

Teri Struck:  And you said they could go back to work within 3 days?

Dr. Simeon Wall: Well I tell everybody to take, for a big liposuction like that I tell everybody to take a week off just to be safe. 

Teri Struck: Right.

Dr. Simeon Wall: So they’re not walking funny when they get to work or not worried about it too much or not too sore.  For smaller areas of liposuction, sure you could go back in just a couple of days but for the large ones where it goes all the way around, those people are pretty sore for a few days. 

Teri Struck: And they’re pretty swollen, right? So how long before they see results?

Dr. Simeon Wall: Yes, they’re swollen but it’s not like they are swollen bigger than they were before surgery. When we take off all of the foam and the garments 5 days after surgery they are already much smaller.  So they will see it right then at that appointment when we take off all the dressings. 

Teri Struck:  Now you say garment, how long do people have to wear garments?

Dr. Simeon Wall: Well I use a lot of foam to provide stability for the skin so we don’t have any rippling or any in-folding or rolls of the skin. 

Teri Struck: Now, excuse me, what is foam?  What are you talking about?

Dr. Simeon Wall:  What’s that?

Teri Struck: Did you just say foam?

Dr. Simeon Wall: Foam.  Right.  

Teri Struck: Really?

Dr. Simeon Wall: Beston[sp] Foam.  It’s sheets of foam (1 inch or ½ inch foam) and we put that on underneath the garment (the pressure garment) and they wear that all the time and it really provides a smooth, smooth result.  I will have people wear that foam for 2 weeks all the time and then I will have them wear that during the day when they are bending, turning, twisting and sitting for another 2-4 weeks but at night I’ll have them wear just nothing. 

Teri Struck: The reason for wearing the garments are to keep the skin tight?

Dr. Simeon Wall: Right, well if you think about it, we are going to take out all of this fat all at once, but the skin hasn’t been taken out so the skin doesn’t know what to do so if you are just walking around with that loose skin, it is just going to start to sag and we do not want the skin to sag.

Teri Struck: Right.

Dr. Simeon Wall: So we want to encourage that skin to go back where we want it to go so we push it really tight up against the body where we want it and we have them wear these garments and that is the difference between getting a bad liposuction and a great liposuction result in my mind. 

Teri Struck: Right, I’ve heard that too.  I have never heard of the foam that sounds really good so they can just be comfortable. 

Dr. Simeon Wall: That is one of my secret weapons. 

Teri Struck: [laughs] You need to share!  You have to share with our listeners.  Alright so one of the last questions.  Where are the scars after liposuction?

Dr. Simeon Wall: Well they are all very small.  They are about anywhere from 2-5mm scars which are very, very small little incisions.  We try to put them in hidden locations, for instance all along the bikini line, maybe 2 to 4 to 6 of these in various parts there and we try to make them not even so it’s not a dead giveaway that they’ve had liposuction.

Teri Struck: [laughs]

Dr. Simeon Wall: On the left and right we don’t put them in exactly the same height or place so they might look like they had a mole there or they had a little scar there and eyes don’t pick up on it.

Teri Struck: Right.

Dr. Simeon Wall: So we try not to make them very symmetrical.  Maybe in the bra line or in a hidden crease in the armpit or in the groin crease so they are all pretty hidden.  I don’t make my incisions out on the tummy or out on the sides like some people do because I think they are a dead giveaway for liposuction and sometimes they heal poorly.  We don’t want any visible scar, no matter how small it is.  We don’t want it to be visible. 

Teri Struck: Right, that sounds good.  That sounds really good.  So, how can you find a surgeon near you?  How would you find a qualified surgeon that would be like you, board certified or somebody that you could trust and not a nurse, I mean nurses are not qualified to do this right?

Dr. Simeon Wall: Oh! Heavens no!  The smartest thing to do for anybody, considering that cosmetic surgery is not regulated anywhere in the United States.  Any doctor can perform cosmetic surgery.  The smartest thing is, you have to start with a plastic surgeon.  There are bad plastic surgeons too so you want to make sure you get a good one and you definitely don’t want to start at the bottom of the barrel where they are not even a plastic surgeon.  The American Board of Plastic Surgery has a list of all the board certified plastic surgeons and The American Society of Plastic Surgeons has a web site http://www.plasticsurgery.org that you can find a doctor in your area and that is by far the easiest and the quickest way to find, just to get a starting point of the real plastic surgeons in your area, http://www.plasticsurgery.org and once you go to there it will direct you to each of those surgeon’s web sites and then you can do your research and make sure they really do specialize in cosmetic surgery and that is a major portion for their practice or in my case, that is all I do. 

Teri Struck: Fantastic.  We want all of our listeners to be safe and we are running out of time and I could ask you a million more questions and I’m sure everybody is going to want to hop onto your table.  If you’re going to want to find Dr. Wall you’re going to have to go to http://www.personallifemedia.com and we will have a link to your web site.  We can’t thank you enough for sharing your time with us, I know how busy you are, and we thank you so much and I think we have learned a lot about liposuction today. 

Dr. Simeon Wall: Well thank you for having me.  I really enjoyed it

Teri Struck: We’ll have you back, thanks a lot.

Dr. Simeon Wall: Thanks.

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