Cosmetic Surgery and Beauty Magazine #64

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there are no reference points to sculpt the body threedimensionally,’
he says. ‘This can mean uneven removal
of fat and, more importantly, a higher risk of penetrating
relaxed muscle.’
While the patient is sitting for most of his procedure,
they are gently moved into a standing position towards the
end to make sure there are no inconsistencies with the fat
removal.
By using only the cannula without energy assistance,
Dr Goldbaum says the fat can be removed intact and
atraumatically. ‘The moment you start introducing energy
assistance, it changes the equation. I believe there is more
risk of things going wrong – it’s the skills that create the
results, not the technology,’ he says.
‘I believe that frying the fat cells with laser energy or
shrinking them with ultrasound compromises the fat cells
– not only to the fat being removed but also the fat which
stays in the body,’ he continues. ‘This is why many patients
experience fat returning some time after their procedure,
because the body is repairing these damaged fat cells.’
Sometimes the problem is too much fat in some places,
and not enough in others. In such cases, fat transfer
can be an effective adjunct procedure when undergoing
liposculpture, particularly for those who are looking for
natural-looking volumisation. ‘One of the other reasons
I don’t use energy assisted liposuction is to preserve the
integrity of the healthy stem cells in the fat if we’re also
performing fat transfer,’ he says.
His ultimate aim, Dr Goldbaum explains, is to sculpt
the existing fat into a nicer shape, not melt it inconsistently
for the sake of removal. ‘We have successfully reduced
the size of large stomach aprons, breasts, hips, thighs,
abdomen, and even harder to reach areas such as the neck
and ankles.’
‘There are sometimes instances where surgery is
required,’ he continues. ‘For example, if a woman has more
glandular tissue than fat in her breasts, this will need to be
removed surgically. However, there are many cases where
women undergo a surgical breast reduction when they
can simply reduce their breast size with liposuction, which
involves two small nicks on either side of the breast instead
of obtrusive scarring. Put simply, if there’s fat, I can remove
it,’ he says.
Safety first
Dr Goldbaum’s use of local anaesthetic to numb the target
areas before surgery means the risks associated with
general anaesthetic are eliminated. ‘Liposuction under
local anaesthetic carries minimal risks; by not using general
anaesthetic we are removing any unnecessary associated
complications,’ he explains. ‘With intravenous sedation
there is a 1 in 50,000 mortality rate and there is a 1 in 5,000
mortality rate for liposuction under general anaesthetic. No
deaths have been reported from liposculpture under local
anaesthetic.’
Patients can be assured there will be little sensation in
the areas to be sculpted, says Dr Goldbaum. ‘There may
be slight discomfort in the form of a slight pinch every now
and then, but this usually passes very quickly.’
One of the most important
aspects of superior liposculpture
results is not just removing the
fat but also sculpting it
Dr Goldbaum stresses the importance of patients
researching their chosen surgeon before entering into any
kind of cosmetic procedure. ‘If you don’t choose the right
cosmetic surgeon you may encounter problems such as
permanent lumpiness under the skin if the fat isn’t removed
in a smooth manner, asymmetric finish on one or both sides
of the body, not enough fat or too much fat removed and,
in some cases, scarring,’ he explains. ‘These problems
are often associated with inexperience, so patients
should always ask to see photos of the surgeon’s results
beforehand.’
‘Ninety-five percent of my patients are back at work three
days after the procedure,’ Dr Goldbaum says. ‘My patients
are typically able to shower and walk about the next day,
can resume swimming a week or so later, and can usually
go back to the gym again after a month. Of course, every
patient recovers at a different pace, so patients should pay
attention to how they feel before doing any kind of day-today
activity.’
In Dr Goldbaum’s experience, most patients have found
the local anaesthetic to wear off within a few hours after
surgery. Patients may experience a change in sensation of
their skin, which may take a month or two to come back,
but Dr Goldbaum says this is a rare complication. ‘We only
infiltrate as much local anaesthetic as needed, no more. It
is also removed with the fat during the procedure so any
residual anaesthetic is very minimal,’ he explains. ‘This also
lessens the likelihood of toxicity after surgery.’
‘My aim is to create the best possible results for each
of my patients, helping them achieve more balanced and
streamlined proportions. Using advanced techniques,
superior three-dimensional body contouring results can be
achieved,’ Dr Goldbaum concludes. csbm
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