File Title
101 Old Short Hills Road Ste 510
West Orange, New Jersey 07052

« Back to Blog

Category: Liposuction

Why is cellulite so hard to treat?

Before we talk treatment, we have to discuss what cellulite exactly is. Cellulite is the visualized interaction of gravity’s influence, affect and consequences on the interactions between skin, underlying connective tissue attachments, and deeper tissues of fat, muscle and fascia.

The fewer (looser) the connective tissue (fibrous) attachments the looser the cellulite. The longer, lower and larger the column of tissue (thighs) the greater the chance for cellulite.

Genetics and age influence greatly the propensity for (or lack thereof) cellulite. Thin skin and fatty tissue show it far worse. Thick skin with little fat and good attachments rarely show cellulite.

The treatments therefore focus on diminishing the variables that can be addressed. Lifting tissues and/or tightening (tummy tuck, body lift, thigh lift, and arm lift) serve to reduce or eliminate cellulite. Reduction of fat volume can aide in reducing cellulite; liposuction and Coolsculpting can both achieve this to varying degrees.

In conclusion, there is no panacea, no magic bullet, no simple solution, but improvements are achievable.

The Summer and Liposuction Garments

Summer creeps up on us. All of a sudden the warm weather is here here and you have unwanted fat. But maybe the prospect of wearing a garment during the summer season is not appealing to you…

You should consider Coolsculpting! It is a permanent fat reduction; No downtime, No recovery and No garments! A good summer solution for you and your fat.

Beauty and Shape

There is something magical about the combination of tummy tuck, liposuction, fat grafting and breast augmentation or lifting: it is the beauty of shape, of curves , of connotation of youth and femininity. It is truly transformational. Please check out the abdominoplasty section of before and after photos to see what I mean!

Patient Testimonial

I have decided to share with my blog readers some of the kind words my patients have had about their experiences with me. So each week for the next nine weeks you will get to read the reflections of former patients. Their words will reveal a lot about me to you.

Dear Dr. Spiro,

Thank you for the amazing result you were able to give me! I truly appreciate your skill and artistry and just wanted to let you know how thrilled I am with my new and improved figure. I just love the results!

Thanks Again!


Patient Testimonials

I have decided to share with my blog readers some of the kind words my patients have had about their experiences with me. So each week for the next nine weeks you will get to read the reflections of former patients. Their words will reveal a lot about me to you.

March 2013

Dr. Scott Spiro,

I started to write a testimonial many times and never really knew where to begin. However, after today’s checkup, thirteen moths after the seven hour procedure (which included a breast lift, tummy tuck and liposuction of the buttocks and hips) I sat in my car in the parking lot of the Atkins-Kent Office building and penned this testimonial to express my gratitude. When I refer to gratitude, I do not just mean for changing my body from what it looked like thirteen months ago, but for being the honest, caring and dedicated doctor that you are.

Seven years ago, I sat in your office after a good friend recommended you. I made an appointment and went to see you. After careful evaluation, you told me to go home, lose weight and not come back until I was ready for the surgery. In fact, your words were, “I am not a diet doctor!”  You knew I wasn’t ready.

I wasn’t ready. It took seven years for me to lose seventy pounds and find the courage to reschedule an appointment and bite the bullet to commit to surgery. Many women and men both say that they are not going to live like “this” anymore. The operative word “this” meaning their out of control body, the way they have let themselves go, but not many have the determination to do something about it.

I am an ex-teacher and have a sales position working in an industry that deals with young people. I had made up my mind that I did not want to be that woman who looked like someone’s grandmother who came to the schoolhouse to work with the students, anymore. So, after joining the YMCA, going to classes, changing the way I eat and losing enough weight to give me the courage to make a second appointment, I was ready. My second visit was a little more refreshing and relaxing. I had done the work. I had lost the weight necessary to have a successful outcome. I made an appointment for the surgery. Dr. Spiro, you have changed my life.

The frightening part of any surgery is the unknown. Everyone responds differently; emotionally, mentally and physically. The only surgery that I ever had, were two C-sections when I delivered my children over thirty years ago. To say I wasn’t frightened would be a lie. I was frightened. I even wrote a letter to my family in the even I didn’t wake up. Deep down, I knew that everything was going to be just fine; it just made me feel better to go through the exercise.

Having finally reached the decision to go ahead, I spoke with three patients of yours. They all had experienced the same procedure I was about to undertake. One woman was forty, one fifty and the third, a sixty year old. All of the women convinced me to go ahead with the surgery, and that was the best decision they have ever made, but it had to be you preforming the operation. I went ahead and have never looked back.

Dr. Spiro, you are the “wizard of artistry”, in your field, as well as a kind, caring and compassionate individual. You are an artist as well as a surgeon. You have made me feel special. No, you have made me feel beautiful. You explained everything you were going to do, sometimes more times than you would have liked to. And, you gave me time to digest the procedure, to my level of understanding.

You looked at me as a human being, one that you wanted to improve physically for my best interest, and because of your artistic talent, you could. You are a proud man and extremely proud of your work. You work un-rushed, are attentive both pre and post-op and have reassured me every time that I had any doubt about myself.

Because of your gentleness, kindness and talent, I also had you perform a full face lift six months later. I believe that because of the weight loss, my face looks even more natural than I ever expected. I look twenty plus years younger and feel great. Wow, what a feeling.

Only a few close friends even know about the surgery, when asked about the pain I cant honestly remember. I guess it is like having children. You forget what it was like. All I know is that when I look in the mirror and see the new me, I am grateful that I made the commitment to myself and I had you as my surgeon.

When you feel better about yourself, mentally and emotionally and then add the physical component to the mix I honestly believe that you become more active and better contributor to society. You make a difference. You are noticed. Regardless of what you do, whether it be working full time, volunteering or taking care of you r family, you must take care of yourself first. If you can’t do it yourself, don’t be afraid to ask for help. I needed help…I asked.

As far as I am concerned, people considering plastic surgery of any kind should not look any further than your office door. Your compassion, talent and your incredible staff is the perfect combination for success. Just like the old slogan, New Jersey and You…Perfect Together. I should read on your door…Dr. Scott Spiro and You…The Best Fit for Now and the Future.


Tummy Tuck Case Examples

So let’s go over some examples of women and then what types of tummy tuck is best suited for them.

A 5’4” tall, 135 pound woman age 48 presents after having two children.  She is active, goes to the gym but complains of stretch marks in lower belly, inability to get a flat stomach despite exercise, and when she wears snug clothing or a bathing suit she looks like she has a roll of fat. During examination, I find that I can grab and move skin of upper and lower abdomen all the way to her hip bone on the side.  What she believes is fat is actually just rolled up loose skin.  Her abdomen is centrally weak. The best solution for her is a traditional umbilical transposition abdominoplasty and flankplasty (repair of abdominal wall muscles, fascia, rectus and obliques) as well as excision of excess skin to hip or just beyond. This will maximize her outcome and give her a shapely, strong, firm, flat, and tight abdomen.  Visit the website for examples!

Next is a 38 year-old woman who is 5’2” and weighs 130 pounds. She has a slightly high belly button position from carrying her pregnancies low and has a low roll of thinned out loose skin which stretches from hip to hip and is 4 inches tall. Her upper skin is tight and of good quality.  She too has a weak middle bulging.  The procedure best suited for her is an umbilical float abdominoplasty & flankplasty with abdominal wall repair.  Her incision is still hip to hip to excise poor skin but since only the lower skin is loose and her belly button starts slightly high, there is no reason to make a surface incision on her belly button.  It is temporarily disconnected on the inside, the abdominal wall is repaired and the skin is pulled.  The upper abdomen only slightly so the belly button moves down slightly (and gets reattached) and then the lower skin is stretched and excised significantly (6-8 inches). She still has an incision hip to hip but ends up with a flat, tight, shapely, strong abdomen.  Visit the website for examples of this too!

Now a 45 year old woman 5’5 and weighs 150 pounds comes in. She has a slightly weak abdomen but really only cares about the loose roll of bad skin pouched above an old c-section line.  She wants the simplest thing that can be done.  So here, an excision and removal of this scar and roll of skin will tighten her lower abdomen somewhat but do nothing to her abdominal wall strength or slight bulge. She is ok with this, so I suggest a ‘skin only’ limited ‘infraumbilical’ abdominoplasty.  The belly button is not touched and the length of the scar is slightly longer than the original c-section but is flat and tighter.  This is the most minor type of tummy tuck procedure.

Of course liposuction can be done to compliment any of these procedures mentioned and I will review that in upcoming blogs.  For now, visit the website to see photos of actual patients!


Fat Grafting

Fat grafting is the process of removing fat from one area of the body which may be in excess and then transferring it into another body location where it is needed or is useful.

Liposuction is used to harvest the fat.  The fat is re-inserted using special needles or cannulas.  I have been performing fat grafting procedures for over 14 years!  I have a special meticulous protocol which I have refines over the years to assure my patients the highest rate of successful fat grafting.

This involves gentle aspiration, gentle filtration, sterile handling, and rapid reinsertion.

I have done fat grafting for lower eyelids, cheek enhancement, jaw line, nasolabial folds, lip enhancement, breast enlargement, chest wall reconstruction, male breast reconstruction, partial female breast reconstruction, as final camouflage in breast cancer mastectomy reconstruction, in buttock lift, augmentation, enhancement, shaping, as secondary correction of scar defects and previous liposuction, and in hand rejuvenation.

The applications are limitless, the outcomes can be magical!

America's Health Front

Dr. Spiro on TV!

I hope you were able to watch my little spot on NBC, Sunday March 25, 2012. We did a segment on America’s Health Front. In it I discussed body and breast transformational procedures, including liposuction, fat grafting, breast augmentation, lifting, body lift, and tummy tuck. We featured several patients who were shown in an exam as well as reflecting back on their experiences. We filmed 2 1/2 hours including in the operating room. Unfortunately, several of our patients who had volunteered, were left out on the cutting room floor!

Try to catch it online or look for it on our You Tube channel (search for Spiro Plastic Surgery) in the coming weeks.

Falsehoods and Urban Legend Regarding Liposuction

Liposuction in New Jersey

Did you catch the New York Times article regarding redistribution of fat after liposuction?  To summarize, it says that if you get liposuction done, the fat WILL come back in other areas. This angers me. Let me point out significant issues with this study. I will debunk their conclusions! Firstly, there is no stratification for patient’s nutritional profile before and after liposuction. Nor, is there stratification for exercise patterns before and after. This is critical because these two factors greatly determine long term success in body contouring. Let me explain. If you eat poorly and don’t exercise and have no plans to change your lifestyle, even with successful liposuction, your good surgical outcome will be short lived. Eventually, you will gain fat mass back. Only now it will go to non- suctioned areas. Liposuctioned sites are less likely to uptake fat due to cell wall disruption from the procedure.

Now take a patient who has not exercised nor has she gone to the gym. What if her poor eating, and lack of exercise is because she is depressed that she is fat or has fat in disproportion to her body. She may be fearful of going to the gym for fear of being the fattest person there. So if she has a plan for lifestyle change, she is apt to be successful! The question some would then ask is why not just make the lifestyle change? Well, for many women fat may be located in difficult to eradicate areas. You can’t wish fat away or spot reduce. Liposuction can be a great jump start. What the article and the New York times fail to account for is the very real changes in pre diabetes, insulin resistance and successful dramatic additional weight loss many women achieve after liposuction.

Finally, this is why some women who eat reasonably well, and exercise moderately, can’t seem to lose weight, but after liposuction, the poorly understood paracrine effect of fat on other hormones, allows some women to loose additional significant weight!!

I hope this helps – be careful how “studies” are set up. They may be trying to prove a point prior to beginning or may not have enough patients enrolled in the study to format it validly with enough stratified groups!

Liposuction in New Jersey

Buyer Beware in Body Contouring

Seeing a number of patients recently with poor outcomes from liposuction previously done elsewhere prompted me to write this blog. A patient came to me with areas of cold fixed thick scarring in her abdomen with other areas of her abdomen unusually thinned out and essentially absent of fat.

The cold feeling to part of her abdomen is from devascularization from over aggressive superficial liposuction using an energy source which produces heat and although liquifies fat can create collateral injury. When these areas heal, they form scarring which is relatively fixed or immobile compared to normal tissue.

So the discussion about liposuction must first start with a discussion about energy delivery to tissues. There are a number of newer technologies available to extract fat. They go by many catchy names and involve a heat delivery system based on laser, internal ultrasound to name a few. The public is often swayed by tempting marketing, promising that these smart technologies provide miraculous fat removal. One problem is that less well trained medical practioners gravitate to these marketing strategies to increase their practice. Instead of marketing good results, they market sexy technology. It can be difficult to predict outcomes when these technologies are used aggressively, but when used minimally, they yield marginal achievement.

Using cold cannula technology, thinner tubes with higher flow systems allows the surgeon to keep the heat source – the surgeon- away from tissues and hence decrease the risk to patient. This is my favored approach. I believe that we as surgeons must leave a little layer of fat in the area we suction. This is only natural. It allows for better healing. Simulating a very lean overall body mass by liposuction is risky. Liposuction should be as an aid to help shape people with inideal shapes, not to rid the body of fat. Once you are shaped by lipo if your ultimate goal is to be extremely lean then the patient must eat and exercise the part. This is the key to success! See the lipo section on my website for cases that depict this! After viewing what I mean, read more below.

The three dimensional approach I take can’t be offered using these other heat sources. They are really only safely reproducible two dimensionally. So, for me it’s a matter of visualizing the female aesthetic and transforming the patient into the best that they can be within reason, safely and reproducibly. I use my approach in 500cc suctions up to 9000cc volumes (which require overnight stay).

Compare outcomes, not fancy names of technology, buyer beware when body contouring!


Promises to fill the needs of our patients who are seeking non-surgical facial & body regenerative skin care.