What’s new. What’s old and what works an expert opinion !


 

Let’s face it, everyone is constantly looking for the next best thing—the most non-invasive, the quickest, the best. Here, we’ve whittled down the craziest new weight loss procedures on the market that—yes—you can do during your lunch break (lunchtime lipo, as those in the know say).
In regards to traditional liposuction, when patients understand my approach, which uses local anesthesia as to general anesthesia, they’re often impressed by how little downtime they experience. Patients will leave my office half an hour after their surgeries, and are able to go home and walk around. The next day, patients are usually up and going, and in as little as two days, most are back at work and doing their daily routines, including light exercise.

 


As a pioneer in the field, he offers multiple types of body sculpting and fat removal procedures that can be done individually or combined, depending on the patient, for a truly customized experience and outcome. He performs body contouring procedures with a keen aesthetic eye and superb level of care. Another thing that stands out about Dr Tawfik Sefrioui or also dubbed as Dr Casablanca or the Body whisperer and Body Shaper of Casablanca , is that he is not the typical “Regular, standard Cosmetic surgeon you normally encounter » His well heeled international clientele tout his style, his caring & humble way of approaching his patients and staff beside his manner and the special interest he takes about details.
As a physician and surgeon, and As a Leader in the field, he offers multiple types of body sculpting and fat removal procedures that can be done individually or combined, depending on the patient, for a truly customized experience and outcome. one of my main responsibilities is to honestly guide, educate, advise and protect my patients.
Since liposuction is one of the major cosmetic surgery I perform and I have done this procedure for years on hundreds of patients, I have a lot to say into the nuances of consistently achieving a great result and making my patient happy. I have spent years fine tuning my technique using different new technologies for liposuction and have a particular philosophy on what constitutes a good candidate for liposuction. The main type of liposuction performed today in Morocco and other countries is traditional liposuction under general anesthesia, It is so much more than sucking out or melting as much fat as possible.

One of the most important points I want to emphasize is the importance of choosing the honesty, integrity, artistry, eyes, hands, skills and good judgment of the surgeon over the machine. The machine is only a paint brush in the artist’s hands. Despite interesting technology and aggressive marketing hype, it will not guarantee a great result in a trusting patient. A concerning trend I have seen in the last few years with the introduction of some of this interesting technology is the mistaken tendency of the patient to choose or ask for the machine instead of spending time to find the right surgeon. Like I say please do your homework and spend time educating yourself. Do not be impulsive, continue to learn and hopefully the truth will come to guide you to a great result.
Presently in the United States, liposuction is still the most common cosmetic surgery. It also has one of the highest revision rates approaching 25% to 35% in some studies. It is much more difficult than most patients and even many naïve surgeons realize to consistently get a beautiful result. There are many reasons for this as we will start to see. I feel it is extremely important to “get it right” even touch ups can be sometimes necessary to make the satisfaction as 100%. Every aspect of this procedure from clear honest communication with the patient, to complete evaluation, to meticulous technique should be directed toward this end. If a patient is not a candidate, e.g. they are simply obese, maybe out of shape but not disproportionate, then I may have no role in their improvement and honestly tell them they are not a candidate for liposuction.
Unfortunately, approximately 50% of my surgeries are revision liposuction where I am using techniques to improve a bad or less than optimum result by another physician . In my evaluation of this patient, I can always tell why a bad result has occurred. A bad result occurs for two reasons: either poor evaluation (including poor communication) or poor technique. The surgeon may have been too conservative, been too aggressive (too common), been uneven in his contouring, poorly blended areas, placed his incision points in strategically poor locations or thrown a patient out of balance and proper proportion. And once again, fortunately new technologically advanced machine handled by a certified surgeon in this technique can prevent these problems. Like a perfect haircut or a beautiful sculpture, it goes back to the skills and artistry of the person doing it.
With liposculpture surgery, as with any procedure, a great result begins with a complete honest evaluation as to who is a good candidate. Simply stated, liposuction is all about targeting areas of genetic disproportion and balancing a body. It has virtually nothing to do with being overweight, underweight or normal weight. It is about focusing on stubborn areas that can’t be taken care of with diet or exercise. This is one reason why it is so important to be fully evaluated from your neck to your ankles by someone with a good eye and ability to determine where you are out of balance if at all. It is a mistake to liposuct someone who is simply overweight or out of shape but not disproportionate. This is why we hear of someone who has had lipo and the fat “went” to other area. The surgeon created disproportion. In addition, make sure that who is evaluating you for surgery is actually the surgeon and not somebody else. I have heard of patients who met their surgeon for liposuction in the operating room for the first time. Be wary of places that seem like factories and do not truly care about comprehensive individualized care.
With regard to my own approach to liposculpture, I strongly feel that local anesthesia is the gold standard and offers many advantages over general anesthesia for liposuction specifically. This is called “tumescent” liposuction . I like to call this pure tumescent liposuction to differentiate it from other types where they maybe combining it with general anesthesia. Tumescent liposuction has essentially three major benefits. To begin with, studies show it is far safer, especially if compared to liposuction done with other procedures under general anesthesia. The second benefit is easier recovery. The tumescent fluid which is infiltrated into the fat helps hydrodissect (separate with water) and allow much more pure fat removal with decreased bleeding. This results in far less bruising and generally much faster recovery with less post operative discomfort. I only trust myself to do all the local anesthesia as there certainly is an art to infiltration so that the patient feels as little as possible. However, the greatest advantage of local anesthesia is that I have a patient that can always be positioned optimally, so that I can meticulously sculpt without ever jabbing the muscle or poking the skin. This allows me to stay only in the fat layer where I only belong. On the other hand, jabbing, poking or tenting the skin with the canula at the wrong angle is one of the main causes of indentations and irregularities (as we will soon discuss).
With regard to my technique of sculpting, it begins with a good eye for the contour, balance and proper proportions for the male and especially the female body. Each body has its own differences, nuances and limitations. Good surgical technique also encompasses excellent judgment for not only where to target but also how aggressive to be. There must always be respect for skin tone as well as knowing how to deal with looser flabby tissue (flab is the term I use which is loose skin and muscle. Many people confuse flab with fat.) Where I have learned to place my incisions in each part of the body I approach is extremely important. The goal is not only to place few incisions in places that hide well, but to strategically place them to be able to completely and evenly approach each area without jabbing the muscle or skin. My incisions are small nicks in the skin between two-three millimeters in length. I feel that not suturing the sites allows faster recovery by drainage of fluid postoperatively.
With regard to how I sculpt, this is a little more difficult to convey in words. I will go details about throughout my next lectures. Liposculpting is a very tactile procedure and this is one of the main reasons why I do not prefer laser assisted liposuction as I loose the “feelings” which convey to me exactly where I am and how much I am bringing an area down. Remember, the goal is not to always be aggressive and just suck all the fat out. This is a very amateur approach and bad results will commonly occur.

Regularly featured on top media programs and training programs and scientific conferences around the world for his expertise in liposuction, Dr. Tawfik Sefrioui employs an artistic, comprehensive approach that revolves around : balance, proportion and precise patient positioning during surgery. He has highly regarded reputation for his skills in body contouring. Additionally, patients from around the world seek out his expertise for revision liposuction and more technical areas.

Water assisted liposuction ( Body-jet ), Energy assisted liposuction and ultrasonic liposuction (eg. Vaser) are newer quite popular alternatives to more traditional forms of liposuction. The argument here goes that some harvest viable fat and others tighten the skin and sculpt the body and liposculture bodies whereas traditional liposuction either does not tighten skin or makes your skin looser, get you bruised for weeks, very painful , long recovery and Very non alluring, but it’s not that simple or truly accurate. I sometimes call this liposeduction vs. liposuction. There are many surgeons that have embraced these newer machines. I Personally has been using these technology together to enhance and less traumatize simply harvesting a good viable fat when needed to be transfered to another area of the body or melting the fat and compiling all these technologies together to well sculpt the body or the area I am working on, I feel I can get as much tightening as I choose by how I deal with the area just under the skin. I prefer this because it gives me more of a feel and satisfaction to see the droopy skin tightening in front of my eyes up to more than 30% on the table then following the patient skin-tightening within the upcoming months in an amazing pattern. With regard to the 4D Vaser Liposuction it’s sealing blood vessels, protecting the nerves with at the same time sculpting the body, getting the best body-coutouring you can expect, remember that with properly done tumescent anesthesia you get very little bleeding, little bruising as less pain due to the hydrostatic pressure and epinephrine vasoconstruction. One well done study in a major peer reviewed journal (Plastic and Reconstructive Surgery Sept. 2006) failed to demonstrate any clinical advantages of laser assisted lipoplasty.
However, I feel the bigger danger with many of the newer aggressively marketed machines is that they encourage the potential patient to search for the machine and forget that what is more important is the mind, hands, heart and eyes of the man (or woman) behind it. Since I do a lot of revision work to improve poorly done liposuction, I would have to say that in the past two years I have seen some of the worst disasters result from both laser assisted and traditional liposuction. Once again, I don’t blame the machine but the judgment and skills of the person behind it. Being a plastic surgeon does not mean knowing how to do a liposuction, most plastic surgery residencies don’t traintheir residents how to do cosmetic surgery until they graduate. Cosmetic surgery is postgraduate specialty as it’s learned by certifications and long trainings . I am also aware that the media plays a large role in hyping up whatever is new.
Finally, with regard to many of the newer machines that are targeting either cellulite or tightening of the skin, I feel this is an interesting area as long as it is not too closely compared to well done liposculpture. There are some great results with regard to this area. Vaser-smooth is an efficient machine for cellulite. There are other machines also used for cellulite like Cellulaze or celfina While this is a very intriguing area, I have not yet chosen to incorporate it in my practice as I am not yet sure it really works long term and is worth the cost of the procedure.

In regards to traditional liposuction, when patients understand my approach, which uses local anesthesia as to general anesthesia, they’re often impressed by how little downtime they experience. Patients will leave my office half an hour after their surgeries, and are able to go home and walk around. The next day, patients are usually up and going, and in as little as two days, most are back at work and doing their daily routines, including light exercise.