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Most plastic surgeons perform liposuction with the patient asleep under general anesthesia; but this method is often inaccurate. The problem is while a patient is lying on an operating table, the fatty areas fall away blending into the rest of the body.

Liposuction under general anesthesia

This makes the decisions necessary for the accurate removal of fat very difficult. In addition, surgeons often use the “tumescent” method – a method which distorts the tissue with large amounts of fluid - adding to the difficulty. 
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These methods are unnecessary and on rare occasions can be dangerous. If enough  tumescent fluid is injected it can disturb the normal fluid and electrolyte (various salts) balance of the body leading to serious complications.


Accuracy in liposuction is important. If too much fat is removed from an area, deformities such as waviness, rippling, depressions or dimpling of the skin can occur. If those deformities occur, the problem is permanent. Often, fat injections are attempted postoperatively to fill in the deformed areas, but injected fat eventually dissolves, leaving the distortion visible. On the other hand, if not enough fat is removed during liposuction, the operation must be performed again.

In regards to using ultrasound during lipsuction, anyone can buy an ultrasound machine, but it offers no advantage to the patient. Only to the doctor who does less work. And there can be serious complications – fluid collections called seromas can occur that require repeated treatments to drain them. Ultrasound can also cause burns to the skin. External ultrasound has been shown to have little if any effect on accuracy.

Power assisted liposuction also has no advantage for the patient. Here too, anyone can buy the machine. While it makes for a little less work for the doctor, it gives him less control over the procedure. The same can be said about laser liposuction, despite the hype about faster healing and less bruising.

As for laser liposuction including cool lipo and the so-called Smartlipo (which is just a marketing term for a laser device), this can also cause fluid collections, skin burns, possible toxic byproducts and again has no advantages. Once again, anyone can buy the machine.

Performing liposuction under local anesthesia

For these reasons, Dr. Howard Bellin developed a highly accurate method of performing liposuction under local anesthesia so that the patient can stand up during the procedure and allow the result to be evaluated (obviously, one cannot stand up under general anesthesia.) When fat is removed, the skin shrinks immediately so the surgeon can make precise judgments during the operation. In this way there is very little risk that too much fat will be removed or that some will be left behind. And the procedure is perfectly safe. This is true body sculpting. What the surgeon sees immediately after the operation is exactly what the result will be later on.

The method works as follows: First the patient is giving intravenous tranquilizers for sedation so that he or she is not completely aware of what is happening. Then local anesthesia is put into the areas to be operated upon. Next, a period of about one half hour is allowed to pass for the anesthetic to become fully effective and to allow the tranquilizers to wear off so the person is able to stand up for evaluation.

A very small incision is then made near the first of the areas to be treated and the liposuction is begun. Only about three quarters of the suction is carried out and then the patient is asked to stand up to be evaluated. At this point it can be determined precisely how much fat has been removed, from what areas and how much more is needed to be done; because as previously noted, the skin shrinks immediately so that accurate judgments can be made.

The patient is asked to lie down once again and more fat is removed. The patient then stands up again and is reevaluated. Areas requiring more reduction are outlined with a temporary skin marker and the patient lies down again for more suctioning. This process is repeated several times with small amounts of fat being removed each time until it looks just right. Sometimes the last little bit of fine tuning is actually done with the patient standing up. All the areas being treated are done in the same manner. At the end of the operation, the patient is given a mirror to see the outcome of the surgery. Long before there is any swelling, both the patient and the doctor can see the precise, final result. Polaroid and digital pictures are taken at that time with the patient standing so that he or she can see them in the weeks that follow and thus feel at ease about the ultimate success of the operation during the postoperative period. What you see is what you will get. This is true body sculpting!

No pain during the surgery

There is no pain during the surgery. After the surgery when the anesthesia wears off there is soreness. It is described as muscle pain, the same sensation one gets after vigorous exercise after a long layoff. No narcotics are needed, but most (but not all) patients take some pain medication for the first day or two. Also, because the local anesthesia is not diluted, the soreness and swelling that follows seems to be much less for several days than there is with the tumescent method. No exercise should be done for two weeks, but most people can return to work two or three days after the procedure.

There will be black and blue and some swelling afterward and an elastic compression garment is worn for two weeks to reduce that effect. Wearing the garment longer is really unnecessary. The black and blue is gone within two to three weeks as is the swelling, but the last little bits of swelling can last two to three months.

One risk is infection which is virtually unheard of. Antibiotics are given after the surgery to prevent infection. The only other risk is irregularities in the skin such as rippling or waviness as previously discussed. This happens very rarely. Dr. Bellin has had to do only four minor touchups in over 1200 liposuctions.

The results of this procedure are permanent. When people gain weight, their fat cells enlarge, they don’t multiply. People are born with a fixed number of fat cells in their bodies. Thus, when fat cells are removed, the few that are left cannot make new fat cells, and the ones that are gone obviously cannot store fat. The disproportion never returns.

Once again, this is an original, unique and highly accurate method of liposuction - true, precision body sculpting.

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