Liposuction | Dr. Forley
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Posts Tagged ‘liposuction’


Saturday, June 30th, 2018

Even small amounts of excessive fat in the neck can produce undesirable contour fullness as we age. When the fat is accompanied by changes in skin tone and elasticity, the reduction of fat alone may produce the unintended consequence of skin redundancy or pleating. The NeckTite procedure provides a minimally invasive option, under local anesthesia, for combining fat sculpting with skin tightening. It utilizes an applicator below the skin to administer a layer of controlled radiofrequency energy that results in gradual contraction and tightening of the skin over 6 months without surgery and without scars. The combination of fat contouring and skin tightening can produce striking changes in the appearance of the neck that can last for years.

35 year old female 6 weeks following NeckTite 1

35 year old female 6 weeks following NeckTite

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Sunday, January 29th, 2012
TUMMY TUCK 36 year old female following 3 C-sections

36 year old female following 3 C-sections

Extra fat or loose skin around the abdominal area can be a persistent problem that does not respond to diet or exercise. When combined with muscle weakness after pregnancy or weight loss, surgery may be the most effective solution to improving the appearance of your tummy. Two procedures to consider are liposuction or abdominoplasty (tummy tuck). Here, we discuss which one may be right for you.


Many factors can affect the contour of your abdomen. Excess fat deposits can produce undesirable bulges or fullness. Childbirth can stretch abdominal muscles to an extent uncorrectable with exercise. Loose skin following childbirth or weight loss can result in an unattractive surface appearance of the abdomen.

TUMMY TUCK 4 months following tummy tuck

4 months following tummy tuck

Abdominoplasty, known as a tummy tuck, is a procedure that improves the contour and appearance of the abdomen by tightening or reshaping the underlying muscle framework and removing excess fat and loose skin. If fat deposits are the only contour problem, they may be correctable with liposuction alone. Muscle that shifts laterally as a result of pregnancy will remain there and creates a weakness that prevents you from attaining a flat tummy. It cannot be returned to its proper midline position with exercise. After significant weight loss, your abdominal skin may become much looser, and sometimes actually hang downward, creating a pleating effect. Skin does not respond to any type of exercise, and similar to stretched muscle, will require a tummy tuck to remove the excess. How much your abdomen can be reshaped depends on several factors. The quality of your tissues is very important and is variable amongst patients. If you are significantly overweight, you’ll get a much better correction if you achieve a more ideal weight before your tummy tuck. To reshape the underlying muscle-based support framework and remove excess skin, incisions are necessary. The length of the incision placed just above the pubis depends on the amount of loose skin correction you require. Any necessary incisions will produce scars. The quality of these scars depends on several factors including your specific healing characteristics. However, most patients view the scars as a worthwhile trade-off for the significant improvement that can be achieved in the shape of the abdomen.


TUMMY TUCK 30 year old female prior to surgery

30 year old female prior to surgery

Age, heredity, and hormonal factors can sometimes counteract our best efforts to attain the type of physical appearance we desire. Even in individuals who are not overweight, localized deposits of fat can occur in areas of the abdomen, producing undesirable contours. Liposuction alone can be used to treat the fat when muscle and loose skin are not contributing to the problematic appearance.

Careful assessment prior to the procedure will determine if this is the right procedure for you. First, you must look at your skin. If it does not hang and it snaps back when pinched then you can expect it to contract well after fat removal. When you inhale and tighten your abs, you will be able to determine the contribution made by the fat under your skin to the bulging of your tummy. When you exhale, the added prominence that results is due to muscle laxity. The difference between the two is what can be treated with liposuction.

TUMMY TUCK  5 months following liposuction of the abdomen

5 months following liposuction of the abdomen

Small incisions are used to insert narrow tubes or cannulas to suction away the unwanted fat. Remember, liposuction is not designed as a weight reduction procedure, but as a technique to blend body outlines more aesthetically. Surgery needs to be combined with a program of fitness and nutrition to achieve and maintain long lasting results.

During your consultation, Dr. Forley will advise you as to the best treatment options to enable you to achieve the appearance that you desire.

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Friday, December 30th, 2011

Men have become an increasingly common presence in the plastic surgeon’s office. Competition in the workplace and the prevailing youth culture have combined to create a desire for self-improvement that may not have seemed as important 15 or 20 years ago. The minimal downtime procedures performed today make their acceptance amongst busy professional men and women very high. The most frequent non-surgical procedures men are having done in our office are BOTOX® Cosmetic, injectable fillers, and Ultherapy®. Surgery often is performed to treat baggy eyelids, excess neck, hip, and tummy fat, and gynecomastia or male breast enlargement.


BOTOX® Cosmetic

Botox® Cosmetic provides a non-surgical way of reversing the crow’s feet, laugh lines, and frown lines produced by the underlying contraction of facial muscles. “Also known as Bro-tox, Botox is one of the most popular non-surgical cosmetic treatments for men” say Philadelphia dermatologist, Dr. Ringpfeil. It works by enabling a smooth skin appearance as a result of blocking the muscle contraction and overlying skin wrinkling produced by nerve impulses. The untreated muscles will allow for normal facial expression to remain unaffected. The treatment lasts from 4-6 months and is performed 2-3 times per year to maintain youthful appearing skin.

Injectable Fillers

Injectable dermal fillers composed of hyaluronic acid, such as JuvedermUltra and Ultra Plus, Restylane®, and Perlane® are indicated in the treatment of folds, wrinkles, or hollowing that results from facial aging. “By adding volume, wrinkles and folds appear smoother and facial contours appear more youthful” says Dr. Forely. The duration of effect is up to 12 months.

48 year old male before treatment

48 year old male before treatment

6 years following ongoing treatment with Restylane®

6 years following ongoing treatment with Restylane®

Another filler we offer is Sculptra® Aesthetic. This product is composed of poly-L-lactic acid (PLLA), an injectable biocompatible material that stimulates the production of the skin’s own collagen. The natural appearing restoration of youthful facial contours is made possible by the skin thickening that results from the gradual deposition of the new collagen. Generally a series of 2-3 treatments at 6-week intervals are necessary to achieve the desired effect. The youthful appearance that results from the treatment can last up to 3 years at which time maintenance treatments can be utilized.


Ultherapy® is a new type of non-surgical treatment that uses ultrasound energy to safely lift and tone the skin without any downtime. The ultrasound image on the viewing screen allows Dr. Forley to see precisely the level at which the ultrasound energy is being delivered. Ultherapy® apparatThe deep layers of the face and neck that have lost their elasticity and firmness over time are targeted by the heat-producing sound waves. Although one treatment is frequently all that is needed, more significant facial and neck sagging may require an additional treatment after 3-6 months. The duration of results can vary but you can generally expect up to 2 years of benefits from Ultherapy®.


Blepharoplasty (Eyelid Surgery)

Eyelid Surgery 75 year old male before

75 year old male before surgery

Eyelid Surgery 2 years following upper and lower

2 years following upper and lower eyelid surgery

Loose, sagging, bulging tissues of the eyelids can make the eye appear smaller and lead to others asking if you are tired or stressed. Blepharoplasty or eyelid surgery removes excess loose skin and fatty tissue that produces sagging and heaviness of the upper or lower eyelids. The eye appears larger, less tired, more open, and brighter.

Liposuction (Neck, Hips, & Abdomen)

Liposuction is a contouring procedure that removes bulges to achieve a more aesthetic blending of body outlines. The type of physical appearance men desire can be counteracted by age, heredity,lack of exercise, and poor eating habits. Long lasting results are achieved when surgery is combined with a program of fitness and nutrition. Liposuction removes excess localized fat deposits through tiny incisions using small tubes or cannulas. The overlying skin contracts to fit the new profile. Areas such as the neck, hips and abdomen are the most often targeted areas for men.

Liposuction Before


Liposuction 6 months after liposuction of the hips

6 months after liposuction of the hips

Gynecomastia (Chest)

Gynecomastia 36 year old male before

36 year old male with gynecomastia

Gynecomastia 8 months after gynecomastia surgery

8 months after gynecomastia surgery

Excessively large male breasts, known as gynecomastia, can produce a feeling of self-consciousness about body image that can inhibit lifestyle choices and daily activities. In most cases, the glandular and fatty tissue enlargement of the male breasts begins during puberty. It is usually a benign condition, but can be associated with hormonal abnormalities that may need additional evaluation. Gynecomastia procedures improve the large breast size by reducing the volume and prominence of the breast fatty tissue using liposuction and directly removing excess glandular tissue via an incision at the lower edge of the areola. Skin excision is rarely necessary as it will generally retract during the healing phase. In addition to the improved appearance, patients also find they are comfortable participating in social or sports activities that they were either unable or unwilling to do before surgery. During your consultation Dr. Forley will discuss and recommend those options that he feels will give you the best result.

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Wednesday, October 26th, 2011

There are several procedures, both surgical and nonsurgical, that can improve a sagging neck. The most common cause of the sagging appearance is loose skin, which is often hereditary and can be more pronounced after a rapid weight loss. Gravity also takes its toll on the formerly taut neck of youth. A history of sun exposure contributes to laxity due to its negative effect on skin elasticity. Excess fat deposits will alter the contour of the neck by producing a bulge. The edges of the platysma, a thin muscle that lines the neck, develop the appearance of thickened cords below the chin and become more prominent with age. We will discuss three options used by Dr. Forley to treat the sagging neck.


Ultherapy® is a new type of non-surgical treatment that uses ultrasound energy to selectively heat the deep layers of the neck that have lost their elasticity and firmness over time. Because the sound waves pass directly below the surface of the skin, the deep support layer responsible for sagging is tightened without affecting the outer skin layer.

Before and 1 Month After Ultherapy of Face & Neck

Before and 1 Month After Ultherapy of Face & Neck 

Following an Ultherapy® treatment, the building of new collagen occurs gradually over the following two to three months. Significant lifting results can be seen due to the combination of contraction of the tissues and new collagen formation. Ultherapy® is often recommended in the early stages of neck aging when surgery is not yet indicated.


Liposuction can be used to remove excess localized fat deposits in the neck and to define the jawline.

Before Liposuction of Neck


After Liposuction of Neck

After Liposuction of Neck

The desired amount of unwanted fat is removed through a small incision under the chin using a cannula, a specialized tube for liposuction. Skin contraction is stimulated by the procedure so that mild laxity will usually not require any additional tightening procedures. Potential bruising and swelling can be limited by use of a compression band for 2-3 days. Many patients return to work within a few days.

Neck Lift

A neck lift restores the contour and appearance of a youthful neck by removing excess fat and tightening the loose skin and muscle that causes a loss of definition.

Before Neck Lift


After Neck Lift

After Neck Lift

To reposition your neck tissues, skin and deeper layers of the face are first very carefully mobilized using incisions located behind the ear. Excess fat may be sculpted using liposuction to further improve the result. The neck bands are treated by use of a specialized row of stitches under the skin to provide better muscle support and optimal contour of the neck.  Excess skin is removed and the incisions are carefully closed to produce fine, minimally apparent scars.

In some cases, more than one factor is responsible for a sagging neck, and a combination of procedures may be necessary. Dr. Forley will discuss the best options for your individual needs during your consultation.


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Tuesday, August 23rd, 2011

Along with the healthy eating habits discussed in Part 1 of this series, you need to pursue a good exercise program following your body contouring procedure. Although liposuction and tummy tuck surgery will be of great benefit to your appearance, the long term maintenance of the result requires your active participation. If you hear friends complaining that the surgical results didn’t last or fat went to other parts of their body after their liposuction procedure, it usually is an indication of a sub-optimal or non-existant program of diet and exercise. Excessive caloric intake of any kind-protein,carbs,or fats-will get deposited as body fat no matter how much prior surgery you may have undergone. The observation that the fat may get deposited in “new” areas not typical for you is because there are fewer fat cells remaining in the areas treated by liposuction. Again, this is an indication that you are not utilizing the calories that you consume in your diet and therefore they are being stored as fat.


When you actively build muscle mass, you burn calories more efficiently and regain a more youthful metabolism. The more muscle you build, the more calories you burn, and the easier it is to keep your weight under control with less obsession about diets and calorie counting. Regular exercise will not only help you lose weight but can improve your mood, prevent health problems, and promote good sleep habits. You will look better and feel better, which can boost your confidence, improve your self-esteem and prevent depression. Staying active also helps manage your blood pressure and cholesterol.

You don’t even need to set aside major chunks of time for working out. Take the stairs instead of the elevator or walk during your lunch break. Dedicated workouts are great, but physical activity you accumulate throughout the day helps you burn calories, too. Physical activity delivers oxygen and nutrients to your tissues and, as a result, your entire cardiovascular system works more efficiently. When your heart and lungs work better, you’ll have more energy to do the things you enjoy. Regular physical activity can help you fall asleep faster and deepen your sleep. A good night’s sleep can improve your concentration, productivity and mood. Physical activity doesn’t have to be drudgery- try yoga, hiking, or an at home weight lifting program. Visit for exercise resources.

To maintain ideal muscle tone, aim for at least 20-30 minutes of strength-training exercises 2-3 times a week. Remember to allow your body to rest in between workouts so your muscles have time to recover and grow. Here are a few recommendations from Wellness 360 for some quick, at-home workouts, which do not require any special equipment.

  • Squats: If you are looking to build muscle and gain strength in both your buttocks and thighs
  • One-Arm Row: To strengthen your upper/middle back and shoulders, and a great way to target those lateral muscles.
  • Push-Ups or the Modified Push-Up: A quicker way to build muscle in the chest, abdominals, shoulders, and arms
  • Shoulder Press: A good way to tone your shoulders and arms.
  • Bicep Curl: To build endurance and power in your biceps
  • Kick-Backs: To get those well-defined arms in the triceps area
  • Plank: Good for overall strengthening and toning of the body

If you’re carrying some extra pounds and having a hard time losing them, it’s tempting to blame a sluggish metabolism. But is your metabolism the only reason you can’t lose weight? And, more importantly, is there anything you can do about it?

In Part 3 of this series, Dr. Forley will discuss how your metabolism can influence your success at maintaining your new shape.

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Sunday, August 14th, 2011

Now that you have undergone a body contouring procedure – liposuction, tummy tuck or body lift – you will want to maintain the benefits…

Maintaining the results you have achieved after cosmetic body contouring surgery requires a long term commitment to a healthy diet and a reasonable amount of exercise. The reason is simple, if the calories you consume exceed the calories you burn, the excess will get deposited as fat. This balance can also be affected by your metabolic rate, which can vary with age. As you get older, you will have to work harder to maintain your calorie balance. Finally, stress can play a role in your life and affect your overall health. Read New York City Plastic Surgeon Dr. Bryan Forley’s advice on how to reduce its impact on your sense of well being.


Good nutrition requires a satisfactory diet. Finding a diet with the right combination of nutrients, that works with your lifestyle and that you can also enjoy is a very individual process. There are many nutrients that make up a routine diet, such as fats, carbohydrates, protein, fiber and vitamins. Below, we will give you a general idea of what each nutrient entails.

Fats are nutrients that give you energy. Fats can either be saturated or unsaturated and most foods have both types of fat. Saturated fat or “bad” fat is mostly located in animal products such as milk, cheese, and meats. If you are going to eat meat try poultry or fish as they have less saturated fat than red meats. Saturated fats are in coconut oil, palm oil, and cocoa butter, which are processed in snacks, coffee creamers, and whipped toppings. Trans fat is another type of “bad” fat that is found in shortening and partially hydrogenated oils, such as chips, crackers, cookies, some margarines, and salad dressings. There are “good” fats, and those are known as unsaturated fats, which help to lower cholesterol. The two types of unsaturated fats are monounsaturated and polyunsaturated. Monounsaturated fat is located in canola, olive, and peanut oils. Polyunsaturated is found in safflower, sunflower, sesame, soybean, and corn oils, and mainly in seafood. Omega-3 fatty acids are a type of polyunsaturated fat that can reduce the risk of heart disease. Salmon or mackerel are full of Omega-3 fatty acids and it is recommended that you should eat 3oz. twice a week. Other sources of “good” fat are flaxseeds and flaxseed oil, nuts, and seeds. It is recommended that 20-35% of your total calories each day come from fat. This includes, no trans fat, up to 10% polyunsaturated fat, up to 10% saturated fat, and 10-15% monounsaturated fat.

Processed carbohydrates such as white bread, white rice, cookies, and soft drinks are made up of simple sugars and refined-flour products, which contribute to the problems of obesity and type II diabetes. “Good” carbohydrates include whole grains, which are less processed and maintain more healthful properties. Whole grains are high in fiber, contain antioxidants and vitamins and minerals, are virtually fat-free, and are more slowly digested and absorbed than refined carbohydrates. It is recommended to eat three servings per day of whole-grain carbohydrates. If you’re looking for a whole-wheat product, the first ingredient listed on the label should be whole wheat. Whole-grain carbohydrates include brown and wild rice, barley, bulgur or cracked wheat, whole-wheat pasta, buckwheat, whole kernel corn, and popcorn. Bran cereals are also a good source as they are the highest in fiber. When choosing breads, select those with at least 3 grams of fiber per slice, and cereals with 5 grams or more per serving.


Protein can help you shed those unwanted pounds and keep your belly full. Quality protein also helps you sustain muscle during weight loss, improve muscle fitness, improve immunity and antioxidant function, build HDL cholesterol, and enhance insulin and leptin function – all of which contribute toward optimal weight management efforts over time. But it’s important to eat the right amount and the right kind of protein to get the health benefits. Seafood is one of the best sources of protein because it’s usually low in fat. Fish such as salmon is a little higher in fat but it is the heart-healthy kind, filled with Omega-3 fatty acids. White meat of poultry is good for excellent, lean protein rather than dark meat, which is higher in fat. Milk, cheese, and yogurt are not only dairy foods but are excellent sources of protein, containing valuable calcium. Choose skim or low fat dairy to keep bones and teeth strong, prevent osteoporosis, and enhance weight loss. Eggs are one of the least expensive forms of protein. The American Heart Association says normal healthy adults can safely enjoy an egg a day. One-half cup of beans contains as much protein as three ounces of broiled steak and they are loaded with fiber to keep you feeling full for hours. Pork tenderloin is great and this versatile white meat is 31% leaner than 20 years ago. The intake of soy protein daily can help lower cholesterol and reduce the risk of heart disease. Combine soy protein foods like tofu with a healthy low fat diet. Lean beef has only one more gram of saturated fat than a skinless chicken breast. Lean beef is also an excellent source of zinc, iron, and vitamin B12. If you are looking for protein on the go, grab a meal replacement drink, cereal or energy bar. Check the label to be sure the product contains at least six grams of protein, and is low in sugar and fat. To get the potential weight loss benefit, experts advise aiming for around 120 grams of protein a day. If you want to increase your protein intake, do it slowly over the course of a week.

Eating a higher-fiber diet has been shown to lower blood cholesterol levels, improve and prevent constipation, and slow digestion. The American Dietetic Association recommends the intake of 20 to 35 grams of fiber a day. There are two types of fiber, insoluble and soluble. Though both have health benefits, there’s a difference between the insoluble type of fiber found in whole grains, carrots, tomatoes, and lettuce, and the softer, water-soluble type found in oatmeal, pears, strawberries, and apples.

Insoluble fiber doesn’t dissolve in water. It helps keep bowel movements regular, and may reduce the risk of colon problems. It may also reduce the risk of hemorrhoids, varicose veins, and obesity (by making us feel full). Insoluble fiber is in: Whole-wheat grain and wheat bran, brown rice, bulgur, seeds, and vegetables (carrots, cucumbers, zucchini, celery, and tomatoes).

Soluble or viscous fiber is the softer type that dissolves in water. When digested, it helps prevent cholesterol from being absorbed in the intestines. This type of fiber is also thought to help minimize the rise in blood sugar levels after a meal, which is particularly helpful for people with diabetes. This type of fiber comes from: beans, oatmeal and oat bran, some fruits (apples, mangoes, plums, kiwi, pears, blackberries, strawberries, raspberries, peaches, citrus fruits, dried apricots, prunes, and figs), and some vegetables (dried peas, beans, and lentils).

Vitamins are essential nutrients that contribute to a healthy life. There are many good reasons to consider taking vitamin supplements. Your body uses vitamins for a variety of biological processes, including growth, digestion, and nerve function. There are 13 vitamins that the body absolutely needs: vitamins A, C, D, E, K, and the B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, vitamin B-6, vitamin B-12 and folate).

There are two types of vitamins, water-soluble and fat-soluble. Water-soluble vitamins are easily absorbed by the body, which doesn’t store large amounts. The kidneys remove those vitamins that are not needed. Fat-soluble vitamins are absorbed into the body with the use of bile acids, which are fluids used to absorb fat. The body stores these for use as needed.

Dr. Forley recommends VitaMedica as a supplemental vitamin program. The morning and evening packets make it easy and convenient to stick with a daily routine. The program provides a combination of vitamins and nutritional supplements, filled with minerals, organic flax seed oil, and antioxidants. It is formulated with nutrients that support glowing skin, hard nails & lustrous hair; strong bones and flexible joints; and a vital cardiovascular system.

If the concept of healthy eating seems challenging, begin by slowly incorporating these recommendations into your diet. Drastic changes are more difficult to maintain long term.

Follow these links to help you with your calorie intake:

NEXT BLOG POST BY NEW YORK PLASTIC SURGEON DR. BRYAN G. FORLEY: The best exercises to maintain your new body shape

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