Laparoscopic GYN and Cosmetogynecologist Thomas L. Lyons MD Advances Practice with In-Office, Local Anesthesia Liposuction

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Thomas L. Lyons, MD, originally believed he’d be performing liposuction for patients under general anesthesia as an adjunct to gynecologic procedures. Instead he cites several benefits of in-office lipo as a separate procedure using local anesthesia. Better cosmetic outcomes occur for patients who can stand at times during the procedure for the doctor to see the patient's correct contours. Additionally, pain and expense are lower, safety and privacy improve with in-office, local anesthesia liposuction.

Women reluctant to reveal the most intimate aspects and details of their lives to any physician other than their gynecologist are now experiencing the benefits of the leading edge practice of cosmetogynecology.

This specialty combines gynecology, female cosmetic surgery and medicine. Patients are offered a spectrum of procedures from body sculpting and anti-aging hormonal treatments to cosmetic improvement of female genitalia.

Surgical and non-surgical treatments of urogynecologic conditions that interfere with joyful intercourse are also frequently requested, according to the International Society of Cosmetogynecology.

Dr. Thomas L. Lyons, MD, globally renowned for his 1989 development of the Laparoscopic Supracervical Hysterectomy (LSH), which leaves the cervix in place for better sexual function post-surgery, is among the first members of the ISCGYN.

He received his training at the Pelosi Women’s Medical Center, a leading liposuction educational facility recognized by the American Association of Cosmetic Surgeons.

“Patients request adjunct procedures including liposuction frequently when they’re scheduled for LSH, pelvic floor repair or endometriosis treatment,” said Dr. Lyons.

Liposuction, a procedure which removes unwanted fat from specific areas including abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck, is the most popular body redefining procedure in America today.

Liposuction Performed In-Office, Under Local Anesthesia

Much liposuction performed by plastic surgeons occurs with the patient under general anesthesia, because often a number of other cosmetic or plastic procedures are occurring at the same time. In this case the true tumescent technique (using only local anesthesia) is not used.

Not only can this cause complications because the patient’s body is stressed (for example, a tummy tuck, butt lift and liposuction happening during the same procedure), but also Dr. Lyons asserts that patients can experience better cosmetic outcomes when lipo occurs under local anesthesia.

“When the patient is able to move and stand up during the liposuction procedure, the doctor can see the correct contours—and the patient can tell you she’d like a little more taken off here, and a little bit there. Under general anesthesia when the patient is lying on a table paralyzed, it’s harder to get liposuction right—people may have to come back for touch-ups, which means more hassle and the expense of additional time in surgery,” said Lyons.

Benefits Include Better Aesthetic Results

Although Dr. Lyons originally believed he’d be performing liposuction for patients under general anesthesia as an adjunct to other GYN procedures, he cites several benefits of in-office lipo as a separate procedure using local anesthesia.

There is less potential for drug interaction and fewer complications reported with this technique than with lipo under general anesthetic.

Still, the main reason is better aesthetic results for the patient with a diminished need to return for touch-ups.

Diminished Pain

Another is the pain factor. Lipo performed under local anesthesia is less painful, because more numbing tumescent solution is used than patients under general anesthesia receive.

Large volumes of fluid -- sometimes as much as three times the amount of fat to be removed -- are injected into the area to be recontoured. Because the injected fluid contains an adequate amount of anesthetic, additional anesthesia is rarely necessary.

The name of this technique refers to the swollen and firm or "tumesced" state of the fatty tissues when they are filled with solution and completely numbed.

“The local anesthesia doesn’t wear off for 12 hours,” said Lyons. “Patients are able to take a break during the procedure and have something to drink or eat. In this way the patient’s blood sugar levels remain stable and the patient just feels better -- more in control. During my training we did a case on an MD (a prior course attendee) and later that evening we had dinner -- the patient was fine.”

Dr. Lyons performs True Tumescent Liposuction on patients under local anesthesia in his office, directly above an outpatient surgical center where he serves as Medical Director.

“Our facility is prepared for any problems that can occur and can transfer patients to local inpatient facilities if necessary,” he said.

Greater Safety

“A patient who is awake can respond when something unusual happens,” said Dr. Lyons about liposuction under local anesthesia. Although rare, there have been cases with a patient under general anesthesia when inadvertent injuries to internal organs have occurred and gone unnoticed because the patient was asleep and unable to respond.

Patients researching liposuction may be interested to discover that many, if not most, plastic and cosmetic surgeons do not receive training on the lipo procedure during their residency, but have to learn it in continuing education courses, such as those at the Pelosi Women’s Medical Center where Dr. Lyons trained.

Liposuction takes time. In a facility time is money, so there is, at times, a rush to complete this portion of a more complex time consuming procedure. Also, general anesthesia adds time to the procedure as well as risks. Since the patients can move, eat, stand and walk around, many of the complications associated with long surgeries can be avoided.

Less Expense

A fourth major factor is the expense.

“Liposuction is an elective cosmetic procedure which insurance will not cover,” said Lyons. “If a patient were to have lipo under general anesthesia in the surgical suite, in combination with another GYN procedure, insurance would not pay for the extra time in surgery.”

Since the lipo is being performed in the office there is no “facility” fee. The fees paid are to the physician only which makes this a significantly less expensive procedure.

Performing the procedure in-office makes it more affordable -- and accessible to the thousands of people clamoring for it today.

More Privacy

Many patients would prefer that no one knows their health particulars, but it’s hard to keep it private when the bill comes from the cosmetic surgery center.

Additionally, thousands of healthcare professionals themselves may prefer that their co-workers are not apprised of their own bodily improvements.

“With in-office lipo the patient can be back to work within a couple of days,” said Lyons. “They can tell their co-workers they had a simple office procedure done by their gynecologist.”


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Patrice Dickey
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