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Get Ready for Summer! Body Contouring with Less Trauma and Downtime

Online Health Chat with Dr. Vincent Poblete

February 9, 2011


Introduction

Cleveland_Clinic_Host: Summer will be here before you know it – with its bare your legs, your arms, your tummy, kind of weather. Will you be ready? There is an advanced laser liposuction procedure using the SmartLipo Triplex™ machine – which requires only local anesthesia - that is performed in a surgery center. This means you don’t have travel far or stay in the hospital for your procedure.

This method of liposuction causes less swelling and bruising, and has a more immediate tightening of the affected body areas. After the procedure, you’ll see a smoother shape overall.

Most patients return to normal activities in about a day or two. That means there is less downtime and more “up” time to show off the new you!

Dr. Vincent Poblete is a board-certified plastic surgeon who also specializes in

  • Abdominoplasty (Tummy Tuck & Mini Tuck)
  • After-Weight-Loss Body Contouring
  • Breast Augmentation, Lift, Reduction, and Reconstruction
  • Facelift
  • Eyelid Lift
  • Forehead/Browlift
  • Rhinoplasty
  • Non-Invasive Facial Rejuvenation

Dr. Poblete is available to see patients at two family health centers:

Avon Lake Family Health Center
450 Avon Belden Road
Avon Lake, OH 44012

Elyria Family Health Center
303 Chestnut Commons Drive
Elyria, OH 44035

To make an appointment with Dr. Vincent Poblete, please call 440.930.2572. To find out more about Dr. Poblete or to locate a different specialist within the Dermatology and Plastic Surgery Institute at Cleveland Clinic, visit us online at clevelandclinic.org and use the convenient “Find A Doctor” tool near the top of the page.

Cleveland_Clinic_Host: Welcome to our Online Health Chat with Vincent Poblete, M.D. We are thrilled to have him here today for this chat. Let’s begin with the questions.


Understanding Liposuction

sara: What are the different types of liposuction being used today?

Dr__Vincent_Poblete: The different liposuction procedures are:

  • Regular tumescent liposuction
  • Power-assisted liposuction
  • Ultrasound-assisted liposuction
  • Laser-assisted liposuction.

alwaysalady: I had liposuction about five years ago, and the results were not as good as I expected. Can I still try the laser procedure?

Dr__Vincent_Poblete: You can have a secondary procedure if you have additional areas that you feel will benefit from laser liposuction. It is best if we see you so we can assess the “problem areas.” What area(s) was treated before, and what is it that makes you feel it is not up to expectation?

beachbum: Why have a plastic surgeon do the procedure rather than an OB-GYN or other specialists?

Dr__Vincent_Poblete: There are two major reasons why a plastic surgeon and not an OB-Gyn, for example, should perform your liposuction?

  1. When you go in for a consult visit, you do not know if you will need liposuction alone or a mini-tuck or a tummy tuck or a combo lipo-tummy tuck. You want to go to someone who can do it all, so you will get an unbiased recommendation. If you consult with someone who can only do liposuction, for the most part, that will be the recommendation you will get.
  2. Liposuction is a surgical procedure and - as with any procedure - there are potential complications. You want to have someone who can deal with those complications - in the event they do happen.

needhelp: Are there health standards that must be met in order to qualify for liposuction?

Dr__Vincent_Poblete: Remember, this is an elective cosmetic surgical procedure; therefore, you must be in reasonably good health to have this done. This is best assessed if and when we see you for a consultation. SmartLipo is best if the main concern is excess fat with mild to moderate skin laxity, and – again - this is best evaluated during a visit. We make it a point to offer patients all of the options in body-shaping so they can come up with a decision they are most comfortable with.

TAGTG2003: Are there specific parameters whereby you recommend diet/exercise alone? Is there a cutoff to where there is too much adipose for this procedure or for whom it might be contraindicated?

Dr__Vincent_Poblete: Studies by The American Society for Aesthetic Plastic Surgery have shown that the best long-term results are achieved by individuals who have an active lifestyle - those who exercise and eat a healthy diet. Liposuction is not a weight-loss procedure. The higher the BMI - body mass index - the less satisfactory the results will be.

donna: What are the benefits of massage after a liposuction? Do you recommend a professional massage, or can I just massage it myself or have my husband do it?

Dr__Vincent_Poblete: We do recommend massaging the treatment area after SmartLipo or liposuction. You, or your husband or partner, can do this. You can also elect to have this done with a professional.

basser: Is the “success” of these procedures the same for men and women? Is it better or worse for a man?

Dr__Vincent_Poblete: Success is very relative. As with any cosmetic procedure, the success of SmartLipo is best judged by the patients themselves.


Introducing SmartLipo

patsy: How is SmartLipo different from regular liposuction?

Dr__Vincent_Poblete: The differences are:

  • It melts, or breaks down the fat before the fat is suctioned out - or aspirated.
  • It improves skin tightening.
  • It causes less bruising because the laser energy coagulates or decreases the bleeding.

For these reasons, there is less downtime associated with the procedure.

jlevert: Is this a painful procedure?

Dr__Vincent_Poblete: Compared to traditional liposuction, from what our patients tell us, it appears that there is less post-operative pain. Most of our patients have reported taking narcotics for only about a day or so. In fact, we had a patient last January who reported that she just took some Advil post-op. It is important to emphasize that each individual has different pain tolerance levels.

HIGHTOT2: How is SmartLipo safer than regular liposuction?

Dr__Vincent_Poblete: As far as safety is concerned, both procedures are safe and have been done extensively. I think The American Society for Aesthetic Plastic Surgery statistics show that liposuction  is the most common (along with breast augmentation) surgical procedure done. With SmartLipo, I have noted that there is less bruising after surgery.

beachbum: How long does the procedure take?

Dr__Vincent_Poblete: Treatment of the abdomen averages about two hours, give or take. If we do a mid-section contouring or a flank/hip area and abdomen, that would be about four hours. This is longer than traditional liposuction because we break down the fat first before we aspirate or remove it with a suction instrument. I do believe that the longer time spent is well worth it.

TwinsMom: What are the side effects from this procedure? If I combine SmartLipo with a tummy tuck, will I need to have it done at Cleveland Clinic's main campus? Is any part of this typically covered by insurance? Do you have payment plans?

Dr__Vincent_Poblete: This can be combined with a tummy tuck. If your concern is excess skin and excess fat, chances are you will have better results with a SmartLipo-tummy tuck or a Smartlipo mini-tuck. We perform this procedure at Cleveland Clinic-Chestnut Commons Ambulatory Surgery Center. Usually, this can be done as an outpatient procedure. Of course, we will have to evaluate you first to make a final, customized treatment plan for you. There are different payment plans and this is best addressed with a Financial Counselor, and you could visit with one at the time of your consultation.


Before the Procedure

TwinsMom: Could you write a little about the process. I've never had liposuction before.

Dr__Vincent_Poblete: The first step is a consultation. We will see you, evaluate your concerns, ask what your body contouring goals are, examine you, and then give you a list of options. You will have the chance to see “before” and “after” pictures, as well. This is a thorough consultation process.

If you decide to go ahead with surgery, we will see you for a pre-op visit. At that time, we will go through the consent form, take your pictures, and give you all your instructions.

On the day of surgery, I will see you at the holding area, mark the areas to be treated, and review our plans. If this is SmartLipo alone, this is done under local anesthesia. You will walk to the operating room, and have the procedure. A number of our patients bring their own MP3 devices so they can listen to their choice of music. One patient even brought his DVD. Once the procedure is done, you will walk back to the post-op area, stay for a few minutes, and then you are discharged home. We will see you the next day for follow- up.


After the Procedure

jlevert: What is the healing downtime associated with the SmartLipo procedure?

Dr__Vincent_Poblete: If performing straight SmartLipo, then it is one or two days. Some patients can go back to work, depending on their work requirements, one to two days after the procedure. If this procedure is combined with a tummy tuck for improved contouring (for those with excess skin), then longer downtime can be expected.

jfile: Is there a risk for DVT or PE after the procedure?

Dr__Vincent_Poblete: There is always a risk of DVT (deep venous thrombosis) or PE (pulmonary embolus) after any procedure. Our  nurse coordinator, Donna, will screen you for risk factors using a spreadsheet. If you have enough risk factors, we will then use Lovenox® for DVT prophylaxis.

seagee: What happens to all that skin after the procedure? If you tend to have less elasticity, will it just hang?

Dr__Vincent_Poblete: This is where patient selection and procedure selection is key. If the main problem is excess fat and there is minimal skin laxity, then SmartLipo is a very suitable treatment. If there is excess skin, liposuction becomes less of an option and you are now looking at some form of tuck tummy, mini-tuck, or a combined lipo-tuck.


Anesthesia

lilac: What type of anesthesia is used?

Dr__Vincent_Poblete: For SmartLipo alone, local anesthesia is used. If this is combined with a tummy tuck or mini-tuck, then general anesthesia is used.

TwinsMom: During the procedure would I be completely asleep or only have localized anesthesia?

Dr__Vincent_Poblete: If we are just doing SmartLipo, you have the option of doing this under local anesthesia alone. If we are doing a combined procedure, with a lipo-tummy tuck or lipo mini-tuck, then you would need to be asleep. Most of the time, this is outpatient surgery.


Surgery Sites

JFT254: Where is this performed? Why is it better at a surgical facility vs. an office setting?

Dr__Vincent_Poblete: We perform this procedure at the Cleveland Clinic Chestnut Commons Outpatient Surgery Center. It is better to have this procedure performed in an accredited surgical facility. The main consideration is patient safety. Liposuction, despite what others say, is a surgical procedure with risks and potential complications.

Legend: Is some of the SmartLipo done in your office?

Dr__Vincent_Poblete: We do the SmartLipo in the outpatient surgery center at Cleveland Clinic-Chestnut Commons. This is in Elyria, OH. I think we have a better safety net if we do this at an accredited surgical facility. This is not to say it cannot be done at the office. I know of several surgeons who do it at their offices, but it is my preference to do it at a surgery center, mainly for patient safety.


Costs

rtoxygen: Regarding SmartLipo, do you charge by the amount of fat being removed or by the areas being treated? Can a patient have just one area done - for example, the lower abdomen? What would be the approximate cost for this? Thank you.

Dr__Vincent_Poblete: We charge by the area being treated. The abdomen is considered one area. The flank/hip area - both left and right - is one area. The outer thighs - both left and right - would be one area. We usually would treat one or two areas at a time. A common treatment would be a combination abdomen and flanks/hip area, so that would be a two- area treatment. If you need more areas treated, I suggest doing this in stages. I recommend you call 440.930.2572 for more information and pricing. Thank you.

TAGTG2003: In general, how much does it cost? Will insurance consider this preventive health/maintenance?

Dr__Vincent_Poblete: The SmartLipo procedure is not covered by insurance.

nola-chitown: What are the costs associated with SmartLipo?

Dr__Vincent_Poblete: As far as costs are concerned, it is best to call our office. I do not have the numbers off the top of my head. I do know that our cosmetic surgery price structure is very competitive.

bunny123: Is it (SmartLipo) more expensive than traditional liposuction?

Dr__Vincent_Poblete: I really cannot answer that because I do not know how much traditional liposuction is. Better yet, please check with our office staff. I did traditional liposuction for a few years – in the late 90s - and I can say that I am more satisfied with the results and patient experience I am getting with this: finer contouring, less bruising, and – consequently - less downtime and less pain, as reported by my patients.

weed: Does this procedure (SmartLipo) cost more or less than traditional liposuction?

Dr__Vincent_Poblete: It is hard to answer that, since other providers do traditional liposuction and I do not know their pricing package. I do know that our cosmetic surgery package - the one offered by Cleveland Clinic Plastic Surgery - is very competitive.


General Questions

rtoxygen: Do you know the approximate percentage of patients who are satisfied with their results?

Dr__Vincent_Poblete: According to realself.com, an online forum that has national participation, about 73 percent are satisfied with their procedures. On a personal level, I cannot give you an exact number. I can tell you that most of our patients are quite satisfied with their treatment results. We offer prospective patients the opportunity to talk to patients who have undergone the procedure. We have found that this is very useful and educational to the ones considering surgery. At the same time, most of our patients are excited talking about what they went through and their results.

hoopmom: How long have you been doing the outpatient procedure?

Dr__Vincent_Poblete: I have been performing liposuction since 1993. A significant majority have been done as outpatient procedures. When combined with a tummy tuck, this may be done as an outpatient or overnight stay.

TwinsMom: Are you board-certified?

Dr__Vincent_Poblete: Yes, I am board-certified. A word about "board-certified": you have to be careful. A lot of doctors claim they are "board-certified." However, the question is, "board certified in what? There may be “board-certified” physicians - but not “board-certified” in Plastic Surgery - performing these procedures.

For more information on the procedure, pricing information and to see “before” and “after” pictures, please call 440.930.2572. Thank you for joining us today.


Closing

Cleveland_Clinic_Host: I'm sorry to say that our time with Vincent Poblete, M.D., is now over. Thank you again Dr. Poblete for taking the time to answer our questions about Body Contouring.

Dr__Vincent_Poblete: Thank you everyone for taking time out and joining us today!


More Information
  • To make an appointment with Dr. Vincent Poblete, please call 440.930.2572. To find out more about Dr. Poblete or to locate a different specialist within the Dermatology and Plastic Surgery Institute at Cleveland Clinic, visit us online at www.clevelandclinic.org, and use the convenient “Find A Doctor” tool near the top of the page.
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