Ultra Complete High Definition (UCHD) Liposuction with Skin Tightening

Ultra Complete High Definition (UCHD) liposuction is a unique form of liposuction developed at Artistic Lipo and Plastic Surgery by Dr. Thomas Su, which all of our surgeons perform. It is very different from regular liposuction and allows us to give our patients much more complete and beautiful results compared to any other liposuction. This is an awake liposuction where patients actually participate by holding their muscles tensed and their bodies rigid in different positions allowing for ultimate control in sculpting the fat, and also the best accuracy for creating smooth shapes and contours. Our methods incorporate many techniques which allow artists and sculptors to create beautiful work, which are missing from regular liposuction done under general anesthesia. It is all about achieving the best feel and control of the fat which truly allows it to be “sculpted” rather than just removed in a debulking fashion. Being awake also allows our patients to stand up where the surgeon can see exactly how areas look with gravity affecting them, something not possible when patients are under general anesthesia. This is by far a safer procedure also because our patients remain awake.

How is UCHD different from Traditional Liposuction?

UCHD is different from regular or traditional liposuction in many ways as the name suggests. Traditional liposuction is not ultra complete, or high definition, nor does it tighten skin. In fact, normal liposuction is quite limited in the fat that is removed and the results it produces. However, to understand this, it is best to understand what plastic and cosmetic surgeons are taught about liposuction in their training. Liposuction is not an easy surgery to perform well or beautifully because the fat does not come out easily and it is difficult to keep things looking smooth or to do it without skin looking loose. Because of these things, surgeons are taught some general principles and tenets of liposuction to guide them. These principles have been around for decades and most surgeons have not questioned their validity. These principles are summarized here:

  • Be conservative in removal. Take only 50-60% of the fat layer.
  • Leave some fat behind. The more you take the looser the skin will be.
  • Remove deep fat. Stay away from the surface (skin). You’ll cause indentations and lumpiness closer to the surface.
  • Liposuction only smaller discrete areas. Don’t use this as a major body transforming procedure for large areas.

These guidelines and beliefs are the reason that most plastic surgeons often don’t do very complete fat removal, and only treat smaller areas of the body. However, patients are often not prepared for only a partial removal (50%) of the fat and unhappy that there is still a fairly thick layer of fat remaining. Others wonder why they still have outward bulges when they were expecting to be flat or curved inward. There is no way to smooth out a large outward bulge unless you sculpt closer to the surface and more completely, which is the opposite of what surgeons are traditionally taught to do.

UCHD is a form of liposuction that was born out of a desire for perfection. Although, there will never be a “perfect” in cosmetic surgery, we do want to create the most noticeable improvement in the shape, not just getting smaller, but also smoother, and with desireable contours following and blending into the body’s own musculature.

“Ultra Complete” (UC) in UCHD liposuction refers to removing 80-90% of the fat layer as opposed to the traditional 50-60%. No one should remove 100% of the fat because that would cause skin to scar down to the muscle. Removing fat 90% requires special skills because now you are removing the surface layer of fat next to the skin which is also known as the “superficial fat layer”. It is with caution that this layer should be liposuctioned because any mistakes or unevenness would leave dimples, divots, or grooves because it is so close to the surface. Making things even more difficult in the superficial layer is the fact that it is very fibrous and moving across it can be complicated by the skin jagging and trying to bunch up unevenly. Realizing this, Dr. Su had to create innovative techniques to stabilize this layer and new techniques to move smoothly with his liposuction cannula. This is how Interactive Lipo was born. Interactive Lipo is the technique of a patient participating by holding their body tense in different positions on the table. The firm muscle surface along with the firm body in different positions allows our doctors to hold the skin and fat layer very firmly so that they can move the instrument smoothly and evenly through the fat. The concept is simple, but this technique dramatically changes how smoothly and completely the fat can now be removed. Until Dr. Su described his technique of Interactive Lipo in 2014 at the AACS meeting, no one else had described this. (read more about interactive lipo)

“High Definition” (HD) in UCHD refers to achieving the natural leanest shape we can, that follows the body’s own muscle contours. On the abdomen, HD could mean seeing a six pack, or just a nice curved in shape where skin is literally right against the muscle. Other doctors have used the term High Definition in abdominal liposuction to describe creating an artificial look of a six pack by injecting fat into the muscle layer along with creating selective grooves (etching). This is not what we do or what our HD stands for.

Our HD liposuction is about sculpting so completely and smoothly that all the beautiful contours of the muscles and bone structure that are hidden can be revealed. This concept can be seen in all the different areas that we do. On the chin and neck our goal is to reveal the neck structure and jaw line. On the waist and back, it is to reveal the smallest leanest curved hour glass shape that defines the upper buttocks. On Celebrity Arms, our goal is to reveal in a full circumferential manner all the beautiful contours of the deltoid, biceps, and triceps muscles which leaves a woman looking lean, toned, and athletic. On our Cankles liposuction, the lean ankle blends into an athletic looking calf muscle. On the man’s chest, the pectoralis major shape becomes visible instead of a drooping chest. This is totally different from the concept of just “getting some fat” to make a bulge “smaller”.

Skin Tightening is a huge benefit of UCHD! Until now, doctors have been trying to find a solution to an age old dilemma. How do you remove fat, make an area smaller, and not have the skin sag? Using traditional methods of liposuction in the deep layer of fat and not removing the superficial fat is what has caused the skin to sag for the many years that liposuction has been around. The skin in most patients has the ability to retract since it does have a fair amount of elasticity. Elasticity is the property of a material to spring back from being stretched. So in most cases the skin has this ability much like a spandex fabric to spring back. However, when there is a layer of fat stuck to the surface of the skin, it actually impedes and prevents the skin from shrinking to its smaller size. If you remove the fat from the surface of the skin as you do in superficial (surface) liposuction then you separate the skin from the fat and it naturally is able to retract back and tighten. Most patients when they hear this explanation understand it and it makes sense. Many surgeons when they see the tremendous amount of skin retraction and tightening that we get are in disbelief and still doubt our results are real. Sometimes, its harder to break ideas that have been imbedded deeply. In any case, the amount of skin retraction that we see and show in our before and after pictures and immediate videos is undeniable. What we have been able to achieve in our practice because of this skin tightening is to avoid doing unnecessary tummy tucks, arm lifts/tucks, thigh lifts, and other procedures where surgeons would typically have wanted to do skin cutting and removal surgeries. An important point is that what we do is all surgeon and skill dependent. It has nothing to do with using a Smart Lipo Laser, VASER ultrasound, radiofrequency energy, or any other skin tightening “device”.

Why don’t other doctors do it?

Ultra Complete High Definition liposuction incorporates a number of concepts that are directly contradictory to what surgeons today are still being taught in their residency programs. The information and concepts being described here in this website have been discovered by Dr. Su and have been confirmed in the thousands of cases that he and Dr. Gruber have performed at Artistic Lipo and Plastic Surgery. Dr. Su has over the past few years lectured on the concepts of Interactive Liposuction and Skin Tightening Liposuction (superficial liposuction), as well as Celebrity Arms. These lectures have directly questioned the validity of common surgical thought in liposuction. However, the lectures have been well received and even reported on in several national publications. Because there is no residency program teaching these topics, it is unlikely that there will be any large movement to incorporate them. In fact, after Dr. Su lectured on his Skin Tightening techniques, he discovered that in the early 1980’s Dr. Gasperoni and Dr. Gasperotti, two Italian plastic surgeons, published quite a bit about the benefits of “superficial liposuction”. However, it has never quite taken off in this country. The main reason is the difficulty level of superficial liposuction that requires the most highly skilled surgeon to do it smoothly, and advanced techniques to give controlled and smooth sculpting. Dr. Su’s Interactive Lipo technique and our surgeons’ experience and skills gives us the ability to do Skin Tightening Lipo expertly.

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