Dear Dr. Reichel:
I am a student in college who is going into music performance. Because of this, I have to maintain a very fit body. In the past year, I have lost 15 pounds, putting me at 114 lbs at 5'4". However, I cannot seem to lose the fat around my inner thighs and knees, where I genetically put on weight. Even when I was a competitive swimmer and in the best shape of my life, I still had this extra weight around my knees and thighs. I'm exploring other options to use a couple years down the road if I cannot successfully shape my legs with exercise. I'm curious: what is the typical cost of liposuction or liposculpture in those areas if it is pretty minor?
Thank you for your question. As far as the liposuction/liposculpture - you sound like you are very fit, with some genetic, exercise resistant, fatty deposits in the inner thigh and knee area. These are actually some of the most common locations to have this. It also makes you the ideal candidate for liposuction. For the inner thighs - this is an area where the skin tends to have a bit less elastic quality than other areas, so I am always careful to not "over-do" this area with liposuction. Having said that, I have had many patients who have come in with inner thighs that actually rub together, and we have been able to sculpt them to where they are no longer touching. I love doing liposuction on the knee area - it looks fabulous. You have to be careful, however, because liposuction of the area just above the knee cap on the thigh is not a good place for liposuction. I would be happy to see you for consultation. Our consultations are all individually tailored, one-on-one with me (and my great cosmetic nurses). For liposuction, the consultation is done at no-charge.
For cost, the cost for one area is $3750 - this is usually regardless of how large the area is. The second area can range from an additional $500 (if really small - like your knees), up to $2200. There is a facility fee of $650 which is for the procedure room, anesthesia, equipment, etc - that covers the costs of our surgery center. It is important to be sure that your surgeon does liposuction in an accredited surgical center for patient safety.
Again, thanks for your inquiry and I look forward to meeting you.
Dr. Jennifer Reichel of Pacific Dermatology & Cosmetic Center in Seattle
Liposuction in Seattle for thighs
Dear Dr. Reichel
Hello, With liposuction, on the thighs, (I have issues from knees up, front and back) I'd like to know a realistic time frame to be to where you could wear a swim suit and swim (exposure to sun) without anything being noticeable. Is it 3-4 months? Also would I need to stay in Seattle for a day or two before driving back over? I do not live in the Seattle area, so I am looking at several hours in the car. I realize you can't give me much till we do an exam and consult but wanted to get a realistic framework. Lost 35 pounds this year (yay me) and it's time for the next step:) Thanks in advance.
First off- thank you for the email, and also congratulations on losing 35lbs!
On the liposuction: Yes, ideally you will need the 3 to 4 months to look good for swimwear. You don't have to worry so much about sun exposure after liposuction. It is more the timeframe to have the bruising and swelling improve. At 3-4 months you should definitely be presentable :).
I would like you to stay in Seattle for the night after the procedure - but you could head back to your home the following day. As far as location - we would need to look at your legs. It isn't appropriate to do liposuction on the front of the leg (above the knee) - it always looks bad and can cause the skin above the knee to sag over the knee. There are tightening devices (like the Thermage) that can be used in this area. Liposuction is great for the "Knee" - which is the lower middle part just above your knee. It is great for inner and outer thighs as well. I offer free liposuction consultations and very much look forward to meeting you in person. Please call my office at your earliest convenience to schedule your liposuction consultation, 206.859.5777, my front desk will get you scheduled as quickly as possible.
Dr. Jennifer Reichel
As seen on Dr. Oz, Fat Harvest and Fat Transfer
Dear Dr. Reichel
I had seen a procedure on the Dr. Oz show where liposuction was performed and (immediately) the fat was used to add volumne under the eyes. It sounds like you do the same thing. I'm wondering if this involves general ansthesia or can be performed as an "out patient"? Also can you advise me of an approximate cost? Thank you, S.K.
To answer your question – you are asking about what is called a fat transfer. I do perform fat transfers. You can do it as part of a true liposuction procedure (where you intend to do a total liposuction, but spend the initial portion of the procedure removing fat cells in a sterile manner and then processing them for transfer to other areas of the body), or you can do a Fat harvest and transfer as a “stand alone” procedure where you do a mini liposuction procedure with the intent of removing enough fat cells for transfer only.
You do not need to be under general anesthesia for liposuction, and certainly not for a “stand alone” fat harvest and transfer. For liposuction, I use twilight anesthesia where the patient is awake, breathing on their own, but very groggy, and may not remember parts of the procedure. However, you are able to talk to me and we listen to music and generally keep our patients entertained. For a simple harvest and transfer, you would need less sedation, but I still like to give my patients at least some valium to keep them comfortable. This means, of course, that you can’t drive yourself home.
For the fat harvest, we do the first transfer at the time of the harvest (isn’t it fun to call it a “harvest”?). We take about 10 times the amount needed for a transfer and we have a fat storage system that allows us to deep freeze the fat and store it for each patient for up to two years.
I believe that fat transfers for under eye grooves/tear troughs gives the most natural looking results of all of the options out there. I love the procedure.
As far as cost, the harvest and initial transfer is around $3000 to $4000. Additional transfers thereafter as needed can be between $375 and $475.
I would love to see you in consultation. Please call my office at 206-859-5777 to make an appointment.
Thank you, Dr. Jennifer Reichel at Pacific Dermatology & Cosmetic Center in Seattle, WA
How much will tumescent liposuction for male gynecomastia cost?
Dear Dr. Reichel,
I need to have tumescent liposuction gynecomastectomy, can you give me a ballpark cost for this procedure? Also, it works best in my schedule to have a consultation on Fridays, does this work for you? And what is the cost for this? Thank you. Keith
Hi Keith – I do consults and procedures on Fridays – here in our North Seattle Ambulatory Surgery Center. We have accreditation with both the AAAHC and with Medicare to assure the highest degree of safety. The consultation cost for liposuction is at no charge.
I have had great results with tumescent liposuction for chest/breast enlargement in men. It can make an amazing difference in appearance both in clothing, and without. The small liposuction insertion sites fade away well. You do have to wear a compression garment for at least the first 2 weeks (and sometimes longer). We will go over all of this at your consultation. You won’t be able to do any heavy lifting or exercise for a several days, but you can usually return to work within 3-4 days. The fall and winter are a great time for this procedure as it is cooler in the “compression” vest.
The cost for tumescent liposuction for male gynecomastia is $3000-$4000 for the procedure with a $650 facility fee added. This is the blanket cost for any “first area”. If you were to add a second area (not that you would be), it is an additional $1000 to $1900 depending on the area. So your total would come to $4250. There is a small cost for the compression garment that is additional.
I look forward to seeing you. Thanks for the question.
Can you do a virtual consultation?
Dear Doctor: I am interested in facial fat grafting and have done plenty of research. I know that I do not want to have it done in my town; I was wondering if you did virtual consultations?
A: Thank you for your email. Facial fat grafting--or fat transfer--is somewhat like a mini liposuction. I love doing this procedure because I feel it is the most natural and best looking of all filler agents. When the fat is harvested, it can be stored in a special freezer system for up to two years and can do anywhere from 2 to 6 treatments in that time period. I have found that most people need at least 3 treatments to maintain the fat long term. While I haven't done a virtual consultation yet, it would certainly be easy to do with Skype. I would be happy to try this out with you as it's a great idea. I look forward to hearing from you.
Dr. Jennifer Reichel, Pacific Dermatology & Cosmetic Center in Seattle
How Is Tumescent Liposuction Different?
Q: I will be having the liposuction procedure sometime in the next 5-6 months. Please tell me what "tumescent" liposuction is? Has liposuction evolved into a procedure where it can be done without complete anesthesia? If not, why can't the doctor use the same drugs that they use when you are having a colonoscopy? I am concerned about the fact that I am not allowed to have any water after midnight. I take medications that cause severe thirst. At night I have to keep a water bottle next to the bed. I heard that when you have liposuction you can't have water the night before.
A: Yes liposuction has evolved into a procedure that can be done without complete (general) anesthesia. In the mid 1980s, a dermatologist named Jeffrey Kline developed the procedure that we refer to as “tumescent” liposuction. It means using a large volume of very dilute anesthesia to numb the areas that are going to be treated. It is very safe and allows the patients to be awake during the procedure. In reality – even if the physician is going to put you under general anesthesia, they should still use tumescent liposuction as it drastically improves the outcome and the safety of the procedure.
I do not put my patients to sleep for liposuction. I use moderate sedation – so that you are breathing on your own and are able to communicate with me during your procedure. Because of this, you can eat and drink normally before the procedure. We recommend that you DO drink water the evening before and the morning of your procedure. In addition, we recommend a light breakfast. We want our patients to be hydrated. Since we are not intubating you, there is no worry about food or liquid aspiration.
However, if you have liposuction done under “complete” anesthesia, you would need to be intubated and would have to refrain from drinking any water starting the night before.
As far as the medications that are used for a colonoscopy – we use similar ones, but not the exact same ones. The reason is that they usually use versed – which doesn’t last long enough to keep you sedated for the whole procedure. I use a combination of demerol and valium for most patients. It works great and patients tolerate the procedure very well.
My liposuction consultations are free, I would be happy to see you and answer any additional questions you have. Please call 206-859-5777.
Dr Jennifer Reichel
Liposuction For Stubborn Areas
I was given your name by my dermatologist here in Seattle. I just wanted to check what the ball park (can be big ball park) is for liposuction of tummy area, and how fat on my arms (chicken wings) gets dealt with. Thanks, CL.
Thank you for the question. With liposuction procedures, I treat "by the area". So, the abdomen (tummy) would be one area. The cost for one area is usually between $3500 and $4500 depending on size and level of difficulty. For additional areas, there is an "add-on" cost which is usually between $1000 and $2000. The first step is to come in for a free liposuction consultation. I am always there for the consultation (very important to meet the physician that is doing your procedure). We do an examination and discuss liposuction and determine if you are a good candidate.
Tummies are the number one area treated by liposuction and patients do very well and get great results. Although you will have results immediately, it takes anywhere from 2-6 months for all of the swelling and healing to be complete.
The most common treatment for fat on the upper arms is also liposuction, although for some patients, a skin tightening laser such as Thermage may be a consideration. I love the results of liposuction for the upper arm. Not only does it remove the unwanted fatty deposit, most patients also get a tightening effect from the liposuction. For some patients, we may recommend a combined liposuction and Thermage to really treat the "chicken-wings".
Thank you for the great Question,
Dr. Jennifer Reichel, Pacific Dermatology & Cosmetic Center
What kind of sedation do you use for liposuction?
Dr. Reichel replies:
I use minimal or moderate “twilight” sedation. This means that my patients are awake and able to talk to me during their liposuction procedure.
Being a Mohs micrographic surgeon, my post-dermatology training was in surgically removing skin cancers on patients who are awake. Having the training and patience to perform surgical procedures on patients who are awake and alert allows us to care for liposuction patients while they are awake. The majority of my tumescent liposuction patients is very comfortable during the procedure and does not need deep sedation. Using only minimal sedation increases the safety of the procedure. My patients walk out of the office, and we insist that they walk around the house or down the block on the evening after their procedure. This decreases the risk of blood clots, and speeds the healing process.
What is liposculpture?
Liposculpture is liposuction. They are really synonymous. However, some experts use the term "liposculpture" when they are treating smaller areas of fat such as on the neck, or the knees. Or they use “liposculpture” when talking about "sculpting" areas on individuals that have only minimal fatty deposits, such as a young athletic female that has a small excess of tummy fat. In my practice, they are the same procedure. Suction assisted lipoplasty is the medical term that encompasses "liposuction", "liposculpture" and "tumescent liposuction".
What is tumescent liposuction and do you use it?
Tumescent liposuction was developed by a dermatologist, Dr. Jeffrey Klein, in the mid-1980s. It means to use a large amount of very dilute anesthetic to tumesce, or swell, the fatty tissues. It allows for removal of fat cells while patients are awake, and it greatly decreases the amount of bleeding and complications. Currently, almost all liposuction is done using tumescent anesthetic whether the patient is awake or under general sedation.
Dr. Reichel does liposuction using the tumescent technique.