Liposuction FAQ With Double Board Certified Plastic Surgeon Dr. Timothy Mountcastle

Dr. Mountcastle sits down with us to discuss some frequently asked questions regarding Liposuction and the procedure details. He covers in this educational video: best candidates, his specialized technique, the healing process, and more! We invite you to learn more by visiting or calling our office directly at 703-858-3208


Dr. Mountcastle:    The best candidates for liposuction are those patients who have an amount of fat that's greater than about one inch of pinching of fat in the particular area that they desire liposuction. You can do liposuction on just about any area of the body, and we do regularly do it on the neck, on the arms, on the legs, on the abdomen and flanks. With the abdomen and flanks probably being the number one area. The inner and outer thighs being the second most common area. The arms being the third most common, and the neck being the fourth most common area.

But, you have to have pinchable fat, or, it doesn't even, I guess, have to pinchable, it's just easier to measure pinchable wise. But you have to have a demonstrable amount of fat that's sitting on top of the muscle. And that's one thing a lot of the times a plastic surgeon would have to differentiate, is how much fat is on top of the muscle versus how much is under the muscle. And a good physical exam by a knowledgeable plastic surgeon, who does a large number of liposuction procedures, and a board certified plastic surgeon at that, would be the best person to differentiate this for the patient. What is unique about my liposuction as opposed to others, nationally speaking, or even locally, is that I do a combination of techniques. There is something called SAFELipo, which is basically a technique utilizing no laser, and then there's also laser lipo, which is a technique using laser, which I combine the two approaches.

The key element of SAFELipo, is you're basically breaking up all the tissue with a special cannula called a "basket tip cannula." You're doing this off of suction, you're not doing any suction while you're using this, 'cause it's very powerful. You're basically breaking up the fatty tissue, and then at the end you're using the same basket cannula to equilibrate the fatty tissue, after you've removed the fatty tissue, to try to give you your lowest chance of divots, or little agglomerations of fat ... You know, you want it to be as smooth as possible.

The laser is the other technique that we incorporate, and we use that to melt the fat and tighten the skin. There are some patients who have lots of extra skin, who come in thinking they need a tummy tuck, and they really just need laser lipo, and they don't want the 2 to 4 weeks of downtime associated with a tummy tuck. Or the big cut associated with a tummy tuck, and they want the quicker turn around time, and they may be amenable, then most patients don't know that you get a large amount of skin retraction with that laser. That's the ideal for someone who gets a lot of laser during the laser lipo. Someone who has good skin, and good skin elasticity, doesn't have a lot of stretch marks, they may be amenable to just having the safe type of lipo, the non-laser type of lipo.

Most patients we combine these two elements, we get the best outcome possible. Whereas, patients who typically do SAFELipo, only do that, and patients who do laser lipo only do that, we use a combination of the two techniques, to get the best technique and tailor it, customize it, to each and every patient that comes in.  I perform lipo both in the hospital, and in the office. The majority of which, I perform in the office. We perform probably around 100, 150 laser lipo procedures a year in the office, under local anesthesia. Strictly local. We give the patient a little oral Valium or Percocet, whatever, to relax them, and then we do the procedure. I also do these in the hospital under general anesthesia for those patients who don't like needles, or would faint at the sight of a needle, or could not tolerate the numbing, which takes around five to ten minutes. Those patients we would do in the hospital. We do them in both facilities, but most of the time, the patients can save $3,000 to $4,000 doing it in the office. It's very comfortable for them to do it. And they're going to get an ultimately better result with the use of the laser, than the machines we have in the hospital are not as advanced.

The healing process, varies per patient. There's some patients who, and when you talk about healing time, you talk about seeing results, as well as just healing. The incision will heal overnight. The drainage may last two, three days, but that type of healing, heals pretty quickly. In terms of the skin retraction, and scar tissue, that can sometimes take two to three months to see all the swelling go down. And there are occasional patients who might have a lot of scar tissue built up in there, even if we've just put a little heat, a little laser in, or a lot of heat laser in. Some people will just scar up quite a bit, and that sometimes takes awhile. Sometimes even years for it to completely settle down, for all the scar tissue to settle down. We're usually pretty quick. The patients up and around in three to five days, usually they get back to work in around three to five days.

My name is Dr. Timothy Mountcastle. My practice is here in the heart of Ashburn, which most people don't realize, is about five minutes from Dulles Airport. We're very centrally located, and we have a full AAAASF certified office, which is the national accreditation for surgical ambulatory surgical centers. So we have multiple certifications. All our staff are CPR trained, as well as we have a full surgical facility.