Surgical phase of VHD Lipo
The choice of anesthesia is normally made during the consultation phase. We offer local, local with IV sedation, epidural, twilight, and general anesthesia. Right before surgery in the pre-op area we mark your body to provide our surgical guide. These markings are very detailed and specific. The markings are defining the outline of the muscle structures, their tendinous insertions and their relationships with the surrounding musculature. The markings require dynamic muscle activity and for example when we mark the ABS you will be asked to perform a modified crunch when laying flat so that the linea semilunaris (outer borders of the abdominal rectus muscles) on both sides can be outlined; then while flat the linea alba (the midline depression that separates the ABS); then you will be asked to stand up and contract the abdominal rectus muscles so that the transverse tendinous insertions (linear depressions between the abdominal rectus muscles that delineate the 6 pack). Then we have you do an isometric exercise by putting the palms together down by the waist and push. This contracts the Pecs so that they borders of the Pec muscles can be outlined so that the definition can be brought during surgery. Another essential part of VHD Lipo is to separate out the muscle groups and the area between the Pecs and above the ABS is marked. Attention is then turned to the Lats and the medial border (by the arm when it is at the side of the body) is outlined with the marker and all of the fat in the arm pit is marked. The removal of this fat markedly outlines the lats and the outer border of the Pecs. Then the hips are marked to give you that V Cut (big upper body and little waist) and define the obliques. This also helps to define the para-spinal muscles (lower back muscles) as well. These are the areas that the majority of the men get.

After the markings are done you are transported to the operation room where you receive the anesthesia of your choice after which you are prepped and draped. Then small incisions about the size of this line ___ are placed in the groin (2), inside the belly button, and one in each areola at the bottom. All incision points have protective plastic skin ports placed. All incisions are strategically placed, small and virtually invisible when healed. A solution called tumescent which contains a pain medication (lidocaine) and a vasoconstrictor (epinephrine) to minimize bleeding is injected into the fatty tissue to prepare the tissue for the Vaser, suction of the emulsified Vaser fat, fine tuning with a liposculpturing cannula and then ultimately chiseling out the muscle structures. The same process is performed on all the areas to be treated. The abdomen, Pec, and axilla areas are treated first in the following manner: The Vaser probe is placed through the groin skin ports and the superficial fat under the skin is treated then attention is turned to the skin port in the umbilicus (belly button) to treat the upper abdomen. Then the incision points in the areola are used to treat the superficial tissue between the Pecs and the ABS at the top as well as the bottom and outer borders of the Pecs. This superficial Vaser work also promotes skin tightening so that it “shrinks wraps” back down on the new VASER Hi Def body. Also from these ports the axilla and inner border of the lats are treated. Now that the superficial work is done the process is sequentially repeated to treat the deep and intermediate fat. The Vaser tissue effect emulsifies the fat making it like a milk shake. Then a traditional cannula is placed to extract the emulsified tissue and it is further fine tuned with the cannula to bring down the subcutaneous tissue (fat layer) to the desired level. After this special techniques are used to chisel out the muscles. After the front of the trunk is complete the patient is turned to the side to perform the same process on the hip to define the obliques, separate out the muscle groups (obliques from ABS) and provide that V look. The exact same procedure is performed on the other side. For men having the above noted areas the procedure usually last about 2 to 3 hours.

With the completion of the surgery you are placed in a compression garment (elastic biking suit) and taken to the recovery room where you will be recovered by the nurse and checked in on by the anesthesiologist and surgeon before being discharged home or to the hotel. The recovery process is 1 to 2 hours.