These are extremely difficult times. I see my colleagues and friends in private practice really struggling. I feel their pain. I’m not sure what the future holds. On the one hand, I can envision pent up demand for Botox and fillers. Given the economic crisis in New York, I’m not sure how willing people are going to feel about paying for surgical procedures.

Certainly, we will be seeing patients who have gained weight at home – the “quarantine 15.” I believe that the options will remain the same: some form of liposuction vs. non-invasive fat reduction. As anxious as we may be to push ahead with treatment, patients should be given the opportunity to lose weight on their own. That will serve to motivate the patient and enhance their results. 

Hardly a person has not experienced the Zoom phenomenon, and more people will be working from home in the future. Camera angles tend not to be flattering, especially when it comes to the neck. People seem to be more conscious of this area than any other. I imagine we will be seeing more patients desiring correction of their necks, whether it be extra skin, fat, or both. Once again, there are both non-invasive and invasive methods available. The vast majority of troublesome necks can be addressed in the office under local anesthesia.

I have been a proponent of standing liposuction for many years. Traditionally, the patient is marked in the standing position. The fatty deposits to be addressed are marked with concentric circles, akin to the isobars on a weather map. The patient then lies down on the operating room table and invariably the fat shifts. Since I tend to perform liposuction under local anesthesia with minimal sedation, it makes sense to me to operate with the patient standing.

Like anything else we do, patient selection is key. It is generally a younger patient with discrete fatty deposits. Most of the time, it is the saddlebag area. It must be performed gently, with a small cannula. For larger patients and larger areas, I do the bulk of the liposuction with the patient on the operating room table, and then have them stand for the “fine-tuning.” Many times I tell the patient that they may require a touch up when the swelling subsides. This can be done in the office under straight local anesthesia in the standing position.

Another innovation in liposuction is to leave the cannula holes open instead of suturing them. The fluid drains out the first night, but the holes close within a day or two. I find that the recovery is much faster and the patients experience less swelling and bruising. The scars are eventually barely perceptible. 

Our board-certified dermatologists and plastic surgeons at Laser and Skin Surgery Center of New York are highly acclaimed world experts with thousands of articles published, countless TV and media appearances, and hundreds of years of combined experience. If you are interested in standing liposuction or any other plastic surgery procedure, schedule an appointment with Dr. Lloyd Hoffman today.