The majority of aesthetic surgery relies on the accurate alteration of both underlying tissue and skin to enhance shape and contour. Lipoplasty, liposuction, or liposculpture is a surgical technique to remove and sculpt subcutaneous fat (fat below the skin) in order to reduce volume and improve contour and shape of various anatomic regions. In general these include the neck, arms, chest, back, hips, thighs, buttocks, knees, calves, and ankles. Results and therefore patient satisfaction are dependent on the patient's anatomy (shape and size), skin quality (the ability of the skin to shrink is in part dependent on its elasticity) and, as I will discuss below, surgical technique.

Lipoplasty varies considerably from office to office. The nuances of an individual surgeon's technique greatly influence the overall result and potential complications. Dr. Kornstein utilizes the 'tumescent' technique, now widely employed by most lipoplasty surgeons, and the use of small diameter cannulas to minimize trauma and help sculpt the fatty tissue.

Conventional lipoplasty removes deep fatty deposits, those furthest away from the under- surface of the skin. This technique effectively reduces fatty bulges, or volume. However, because of the thickness of the underlying fatty layer that is left attached to the skin, retraction or shrinkage is uncertain. Since skin is the passive participant in lipoplasty, the superficial technique is the only way to enhance retraction or shrinkage. Superficial lipoplasty removes fat closer to the undersurface of the skin, making the skin and attached subcutaneous fat thinner and more pliable so that it more readily conforms to the underlying contour.

To further enhance these techniques, Dr. Kornstein employs a more recent innovation known as power assisted liposuction, or PAL. PAL replaces the conventional cannula and improves its method of action, thereby reducing trauma to the area being treated. Decreased friction at the skin incision results in faster healing and smaller scars. Patients also report less swelling, fewer bruises and little to no discomfort.

While lipoplasty reduces volume and sculpts the body, measured in circumference not pounds, through the permanent removal of fat cells, autologous fat grafting adds fat cells. Regions in need, either naturally occurring or post surgery (scars and liposuction depressions), cellulite depressions and areas requiring aesthetic enhancement (eg buttock), capitalize on the transplantation of anti-aging fat stem cells.