Sanjay Parashar MS (Gen. Surgery) DNB (Plast) MCh (Plast) FICS (Plast)
CEO and Director Consultant Plastic Surgeon and Laser Specialist Consultant Plastic and Reconstructive Surgeon Fellowship, Aesthetic Surgery (Australia) Fellowship, Plastic and Craniofacial Surgery (Australia) Cocoona Centre for Aesthetic Transformation
Dubai, UAE
Forewords Prof. Luiz S Toledo
Prof. Ashok Govila
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Art of Abdominal Contouring: Advanced Liposuction
First Edition: 2016
9789352500239
Printed at
5Dedicated to
My mom, Late Mrs Malti Parashar, my father, Mr Yadunath Parashar and my wonderful wife, Sangeeta (who I call iron lady of my house and organization) and kids, Sanjana and Sidhant.6
7Foreword
It is with great pleasure that I write this foreword introducing Dr Sanjay Parashar's work. Dr Parashar has been a colleague and a friend for many years. He has been working in plastic surgery for over 20 years. In 1995, he passed two exams in plastic surgery in Mumbai University and National Board of Examination, New Delhi, working in Mumbai, New Delhi and Nagpur. He then traveled the world working in some of the leading institutes in Australia, USA, Bahrain, and South Korea to refine his skills in craniofacial surgery, aesthetic surgery and laser surgery.
Dr Parashar has now been living in Dubai for many years and has established a solid successful career in plastic surgery, specializing in body contouring, breast surgery and craniofacial surgery and has evolved his skills to other areas of aesthetic medicine, such as the use of Botox, and filler injections for face.
Since moving to Dubai, he understood the benefits of day-surgery procedures in reducing cost and stress to patients. Following this new tendency in the medical world, he opened Cocoona, a center of competence, specializing primarily in cosmetic surgery, and nonsurgical aesthetic procedures. Recently, he added the specialties of orthopedic and bariatric surgeries.
Dubai is becoming known as a center of excellence for medical tourism and Dr Parashar has been contributing to this phenomenon, attracting patients from different countries and producing fine work in his clinic and gathering a number of specialists from other areas to cover many aspects of medicine.
Since 2013, when I as Scientific Director of the Emirates Plastic Surgery Society (EPSS), started organizing monthly meetings in Dubai, he has been very active as a lecturer and has helped to elevate the standards of plastic surgery in the region by sharing his experiences and teaching young plastic surgeons and his colleagues in the UAE. He is one of the most active local members of the International Society of Aesthetic Plastic Surgery (ISAPS), participating in our local ISAPS course in Dubai as an excellent teacher and lecturer.
I recognize in Dr Parashar, the skills of someone with a young spirit, keen to learn and to teach, spreading his knowledge in all medical fields and thinking constantly on how to make things better for the benefit of the patient. He is doing both here in Dubai and with his charity work back in his home country, India. He has covered for my clinic many times in Dubai and I have only heard good things about his skills and bedside manners. It is indeed a pleasure to write this foreword, and I am sure this book will help many young doctors to become as successful and upright as Dr Sanjay Parashar.
Prof. Luiz S Toledo MD
Consultant Plastic Surgeon
Author and Innovator
9Foreword
I know Dr Sanjay Parashar, author of the book since his college life in plastic surgery as an artist. His attempt to compile a book of this dimensions that has covered the detailed anatomy of the abdominal wall in the context of liposuction and abdominoplasty procedures deserves all possible compliments.
Art of Abdominal Contouring: Advanced Liposuction is a textbook that covers abdominal contouring in an extensive, detailed and scholarly manner.
Each chapter is not only replete with the latest scientific information, but also accessible and practical for clinicians.
The book covers the history and modern methods of liposuction. The information is state-of-the-art and incorporates the most current information on virtually every aspect of body contouring.
The chapter on aesthetic subunits is unique and informative, and it gives a different perspective to the surgeon operating on the abdominal wall.
There are extensive discussions on essentially all problems and potential complications of body contouring surgery.
I am sure our colleagues will find this new offering to be not only the most extensive and convenient compilation of information in our field, but also the most clinically practical and up-to-date resource in aesthetic surgery.
I wish him a great success with this dream project.
Prof. Ashok Govila MS FAIS MCh FRCS (Glasgow)
Majestica Cirúrgia Plástica
Consultant Plastic and Aesthetic Surgeon
11Preface
I learnt as a student “Publish or Perish” while that is true this is not the sole reason to publish this book. During my training as a surgeon and plastic surgeon, I read many books and acquired a lot of knowledge, but there is always something that you learn without books. Your practical experience, teaches you a lot and this is what I wanted to put together in the form of a book.
Liposuction is one of my favorite operations, although it appears simple and I thought, it is the easiest operation to learn. It took me two decades to understand the concept of liposuction and how to effectively apply it on a patient. One of my mentor said “I hate doing liposuction as patient do not see the difference” and that gave me an opportunity, he passed on all the liposuction that he hated to do and I developed that as my forte.
One of the reason, I learnt a lot was that I had the opportunity to see the patient regularly on the follow-up period. The positive result was very motivating and my passion grew stronger. After a journey of more than 15 years and performing nearly 8000 liposuction procedures, I decided to put my thoughts together for my fellow colleagues and trainees.
In this book, I have tried to cover all the aspect that is important for abdominal contouring. Each chapter has clinical relevance and my own thought process as well. The key element is the understanding of aesthetics of abdomen and how to apply it in various body weight people to achieve a dramatic change that persists for long-time.
I have discussed, almost all the modalities of liposuction that I had opportunity to work with. I have also included a chapter on nonsurgical management of fat, so as plastic surgeon, we look at this option without cynicism and include that in our armamentarium.
I have also discussed about the complications, why it occurs and what we can do to prevent it. This is to re-emphasize that complications can be reduced to negligible, if we follow a standard protocol.
This book will help to stimulate your thoughts to advance the concept of liposuction and body contouring. This will help the younger trainees to think with different perspectives and understand this art. It will also be useful to colleagues who are not performing this procedure very frequently. Finally, will be appealing to fellow colleagues with great experience in the field of liposuction and will allow me to have a healthy discussion with them.
It took me over a year to complete this book, and I kept adding content as I felt I have to tell more. In a conference when I present, I always feel that I have insufficient time to express myself. But I have found this a wonderful platform to “express it all” to “share it all”.
The challenges I have faced to write this book was collecting photos. This has taught me to record all the procedures meticulously as we perform the surgery and organize it well.
I sincerely hope that all the readers will find the information useful and help them perform the procedure safely with high quality result.
Sanjay Parashar MS (Gen. Surgery) DNB (Plast)
13Acknowledgments
I have thank my teachers and mentors who have helped me learn and made into the surgeon, that I am today.
Dr Mukund Jagannathan, my lecturer from BYL Nair Charitable Hospital, Mumbai is my greatest inspiration. I am a successful person because of him. Dr Uday Bhat, my senior colleague helped me understand anatomy better. My first exposure to liposuction was with Dr Ashok Gupta (1996), in fact my journey in aesthetic surgery began with him. I have learned a huge lot from him and I sincerely thank him being my mentor.
But, what made me a fine aesthetic surgeon was my experience with Dr Tariq Saeed in Bahrain from 1997. That was the turning point of my life. He made me believe complications are not acceptable in aesthetic surgery. This is where I was introduced to first generation Ultrasonic Liposuction and we performed several ultrasonic assisted liposuction (UAL) and believe me, we did not have a single complication. I cannot thank him enough for this valuable lesson.
When I was working with Prof IT Jackson as a craniofacial fellow in providence hospital, USA, I realized, how important it is to perform aesthetic surgery to keep a balance and run our domestic economy. I assisted him in liposuction and other aesthetic surgery after hours completing the routine operating list of craniofacial surgery.
My subsequent exposure was with Dr Tony Moore (2004) in Australia. He taught me time management and efficient ways of performing surgery. Abdominoplasty appeared very simple in his hands and it did not take the time, I would think. And that was it, after that I was on my own. And then I was sharing operating room with the mighty Dr Luiz Toledo in Dubai, UAE. I think, I absorbed a lot of energy from him by merely being in the same operating premise.
My biggest strength is my team, my staff who has tirelessly worked with me to provide the greatest care a patient can receive before and after the surgery. My nurses, Ellen Baldivino, Mini Johnson, Asha, Lizi, Arya, Caleen, Rahat, Shiny have provided unending support to our patients and to me. I am thankful to them from the bottom of my heart. I wish to express my heartfelt thanks to my patient co-ordinators, Brenda Castino, Dr Dhey, Rhoda and Smita Molla for logistically assisting me and the patient to accomplish the surgeries successfully.
Special thanks to my administrative team, Shahid, Kashif, Shima and rest of the team for being ever enthusiastic and supportive. I would also like to thank my team of aestheticians under Dr Dalia Ibrahim and Smita Sonovane who have helped our patient postoperatively to improve the results. They are also key people to provide nonsurgical weight loss program to the patient. Front desk team including Shayma, Christina, Russel, Mary Jane for facilitating patient consultations and follow-ups. A special thanks to Jay Peralta Repayo, my videographer/graphic designer for helping me with images and illustrations.
We would also like to thank Mr Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Chetna Malhotra Vohra (Associate Director), Ms Angima Shree (Development Editor), and the production team of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India.
Sincere thanks to Dr Mazen Arafat, who worked with me as specialist plastic surgeon and as colleague and friend.
Last but not the least my family. Sangeeta Parashar, my wife continuous support to me both at home and in the office. Being a doctor, she understands my pain, tantrums, and challenges and have been tolerating me. I am thankful to her. My daughter, Sanjana and son, Sidhant have always been understanding and supportive. I regret spending time away from them, but feel proud that they understand me. Thank you!14