Dr. Salzhauer, we have Edgar on the line from Miami. He's interested in some information on some love handles.

Dr. Michael Salzhauer: Sure.

Edgar: Mike.

Dr. Michael Salzhauer: Hi.

Edgar: How's it going? It's Edgar Romano.

Dr. Michael Salzhauer: Hey, Edgar. How you doing?

Edgar: Good, good. Listen, Mike, a question regarding love handles that maybe you can enlighten people out there. What is the better way to go? Obviously, getting them cut off is not considered part of a tummy tuck. What's the difference between having it lipoed out or is it better to just cut it out? Obviously, something's left hanging there once you suck the stuff out.

Dr. Michael Salzhauer: Well that's a great question, Ed. Well, it depends on the particular situation. A lot of times, if a patient's in fairly good shape, you know diet and exercise down to their ideal weight as much as they could and they're just left with stubborn pockets of fat and a little pot belly maybe and a little love handles on the side, in those cases, again, assuming that they're completely down to what we say goal weight, so to speak, liposuction can work well. However, if they're not quite up to that place yet in their weight loss and so forth, or they've been quite overweight, let's say more than 30% over their ideal bodyweight, typically then the skin will stretch, and when the skin stretches, okay, taking out the fat that's underneath will leave you with hanging skin. So for the skin that's in front of the abdomen, the only solution for that is a tummy tuck where you actually go in, lift up the skin and the fat, sew the muscles together to make them tight, pull down the extra skin and cut off whatever skin would be hanging, would you have just done liposuction. Now, as far as love handles go, often they can be addressed with a tummy tuck. In some cases they can't without extending the incision clear around to the back, and that's called a lower body lift, and that's more typical in cases where people have lost, let's say, 100 pounds and they really have a lot of extra skin. We call that massive weight loss. Typically those patients have had gastric bypasses and that sort of thing to encourage that kind of extreme weight loss, and again, that's called a lower body lift and that is an operation that is a little different than a tummy tuck and that the patient is either turned onto their stomach during the surgery and the excess skin from all the way around the back is excised. Again, that's called a lower body lift. But that is the best way to address the extra skin that hangs after one's either lost weight of had liposuction of those areas and the skin hasn't contracted back. That's a great question, Edgar, thank you for calling. I really appreciate it.

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