Practice Information
Dr. David P Rapaport is currently one of only thity Plastic Surgeons in the United States to be using Bodytite

New Technologies in Lipisosuction and Body Contouring

In the past several years new technologies have attracted considerable attention in the field of Liposuction. The most talked about has been Laser Assisted Lipolysis. This refers to using Laser energy to help perform Liposuction. Different companies have attached different names to their devices, the first and best known being SmartLipo, manufactured by a company named Cynosure. Other types of Laser assisted Lipo include SlimLipo, SmartLipo and CoolLipo. While there are differences between these tools, they are all very similar, using a small (1mm) Laser fiber which releases energy at high temperature, basically melting the fat cells.
There are two potential advantages this offers in Liposuction. The first is that in areas where the fatty deposits are more dense and fibrous, such as the male breast, the upper abdomen, or sometimes the arm, the laser energy can melt through the dense tissue and thereby allow for better and more thorough removal of fat. Ultrasound assisted Liposuction also offers this advantage, with the only advantage of laser over ultrasound being that the laser fiber itself is small and remains cool; the ultrasound cannula is made up of titanium and heats up during the procedure, potentially leading to move irritation of the scar. The other advantage claimed by SmartLipo is skin tightening. This remains a very controversial claim. The method of tightening, if it occurs, is by tissue heating. The problem is that the fiber tip is extremely hot-over 400 degrees Fahrenheit, and the heating produced by such a small and hot tip is very erratic and irregular.

Monitoring of heating is also very imprecise and therefore most experienced doctors using laser for Liposuction do not dare heat the tissues to the level that may cause tightening because the risk of full thickness burning of the skin, resulting in permanent scarring is so high. Indeed, often the most amazing claims concerning laser assisted Lipo are made by non plastic surgeons, usually doctors who have little or no prior Liposuction experience and have acquired SmartLipo or similar devices as a way of getting into the lucrative cosmetic surgery market. In this setting it is important that anyone considering Liposuction understand that the most important factor in achieving a safe and pleasing result from Liposuction is the skill level of the person performing the procedure. Such skill will generally come as a result of excellent training and experience.

The newest technology in Liposuction uses a different form of energy applied to the tissues, this being called bipolar radiofrequency. This form of Liposuction is called Radio Frequency Assisted Liposuction, or RFAL, with the only company currently in the field calling it BodyTite.

Just like after advanced technologies used in Liposuction, BodyTite involves the application of heat-producing energy during the procedure with the goal of breaking through more fibrous tissues and producing tissue tightening. There are several features of BodyTite that are unique and seem to be promising for improved results. Firstly, the radiofrequency energy produced in BodyTite passes from the probe, which is placed in the fat, to a second probe, which rests on the skin (see figure). This causes heating over a generalized area rather than a small spot, as is the case with SmartLipo. Second, the temperature of this heating loop is continuously monitored by sensors, which stop the energy production at any point where the tissues have reached a preset temperature. Early results with the BodyTite are very promising, with demonstration of tissue tightening in several areas, including abdomens, arms and necks, which did not seem possible with conventional liposuction alone. While approved for use in Europe and Canada, BodyTite use in the United States is currently considered investigational. Dr. Rapaport is one of a very select group of plastic surgeons using BodyTite in his New York accredited surgical facility. BodyTite is offered as an option to patients who need tightening but who prefer not to undergo more invasive procedures, that involve actual removal of loose skin, such as abdominoplasty (tummy tuck), brachialplasty (arm tuck) or neck lifting procedures.

Anesthesia options in Liposuction


There are 3 general options for anesthesia in people undergoing Liposuction: Local anesthesia, General anesthesia, or sedation anesthesia, also sometimes called twilight anesthesia.

All Liposuction, whether or not it involves advanced technology, such as BodyTite, laser, or ultrasound, involve the injection of dilute numbing medicine (lidocaine) and an ingredient which constricts blood vessels called epinephrine. The dilute lidocaine causes a general numbing of the area and the epinephrine constricts blood vessels so there is little bleeding during the procedure. When Lipo is performed under local anesthesia, it is this injection that makes the procedure tolerable. However, when Lipo is performed under pure local anesthesia, the lidocaine concentration must be higher to allow for adequate numbing. However, safely concerns relating to the risk of lidocaine toxicity and overdose limit the number and size of areas that can be treated by the local Lipo technique. Typically the local technique is best used to treat on or two relatively small areas. Additional areas can be treated on difficult days. The patient is generally premedicated with oral medication to relieve pain and promote relaxation (such as Percocet and Ativan). Dr Rapaport has been performing Liposuction procedures using local anesthesia for over 15 years. The sedation technique is the technique Dr. Rapaport uses for the majority only of his Liposuction procedures. It involves having a board certified anesthesiologist administer medications through an IV. The patient remains conscious, breathing on his or her own, responding and often talking throughout the procedure. The IV medications are extremely, short acting and allow the anesthesiologist to better assure patient comfort; following the procedure the patient feels alert and relaxed, typically with no memory at all of the procedure. This technique allows for a more standard numbing (lidocaine) concentration in the injected solution, and therefore more area can be treated. A typical Lipo under conscious sedation may treat the abdomen, hips, waist, and inner and outer thighs all is less than 2 hours in a safe outpatient setting.

Manhattan Plastic Surgeon Dr. David P. Rapaport was named one of New York Magazine's Top NYC Plastic Surgeons. Dr. Rapaport is a Board Certified Plastic Surgeon in private practice in Manhattan, New York. He is one of only a handful of plastic surgeons in Manhattan, New York with such an ideal plastic surgery training background combined with nearly 20 years of practice experience. He has performed thousands of liposuction surgeries.

Dr. David P. Rapaport remains on the forefront of liposuction and aesthetic medicine. He performs all his plastic surgery procedures on-site in his fully accredited boutique style surgical facility. His surgical suite is intimate and personal and includes a fully trained and caring staff. During your consultation, you can trust Dr. Rapaport to be honest and open about what procedures and techniques he feels are best fitted to your wants and needs, and he will never try to sell you on "gimmicky" technologies whose marketing has preceded the research. Safety and results are Dr. Rapaport's number one priority.

Dr. Rapaport, studied medicine at Boston University Six-year Medical Program (having been admitted at age 16) before transferring to Israel's Tel Aviv University, where he earned his medical degree. He trained in plastic surgery at Boston's Beth Israel Hospital, a major teaching hospital of Harvard Medical School, and then completed his plastic surgery training at the New York University's Institute of Reconstructive Plastic Surgery, widely regarded as the nation's top plastic and cosmetic surgery residency program. From 1993 to 1997, Dr. Rapaport was a key faculty member at the University of South Florida, where he developed a successful and respected practice as a cosmetic plastic surgeon. During his four years in Florida, he also helped craft legislation requiring broader insurance coverage for reconstructive breast surgery, directed the cosmetic surgery education of residents, and started a private plastic surgery practice.

In 1997 he returned to New York City and opened his private plastic surgery & cosmetic surgery practice on Park Avenue in Manhattan, New York. If you have questions about plastic surgery, or cosmetic surgery, or would like to schedule a consultation with the Board Certified Plastic Surgeon, please phone David P. Rapaport's Manhattan, New York Plastic Surgery office at 212-752-1129 or email the doctor at info@drrapaport.com.

June 13, 2008 - Dr. David P Rapaport is featured in the Summer/Fall 2008 edition of NewBeauty magazine, which is due in newsstands the first week of July. Oct 6th 2003 - Board Certified Plastic Surgeon, David P. Rapaport, MD Named As One Of NY's Top Plastic Surgeons by New York Magazine in their Best Cosmetic Surgeons Issue