(We'll keep your information confidential).

home  ›  blog

Tuesday, April 2. 2019

Category : Facelift / Tuliplift

Tuesday, April 2. 2019

Did you know that the mini Facelift called "Tuliplift" can be performed under local anesthesia?

Many patients and physicians are quite surprised to hear that a cutting / surgical facelift can be performed completely under local anesthesia. I have been practicing Dermatology and Cosmetic Surgery since 1999. During this time I have performed hundreds of face, neck, eyelid, and body surgeries under local anesthesia. Mild sedation with oral valium and an injection of a pain killer (such as Demerol ) is all that is ever needed.

I have developed a procedure that involves the removal of excess skin AND tightening of the muscle (fascia and SMAS plication) that can be performed under local anesthesia. Some patients decide against having a facelift because of the risks associated with general anesthesia. Our trademarked Tuliplift procedure is performed without general anesthesia.

Here are the steps involved:

The skin is prepped in a sterile fashion in our operating room.

A dilute solutioon of numbing called "Klein Solution" is injected into the neck and face are

Excess fat is gently suctioned by hand (not a machine)

excess skin is marked off and removed from in front of the ears and behind the ears

SMAS / facial Muscle is tightened using permanent and dissolvable sutures

Skin is gently re-draped and sutured with dissolvable and semi-permanent sutures

sutures are removed 7-10 days later

2 weeks later the scars are reduced using Mixto fraction resurfacing

cost $15000-$25000

 

 

Tuesday, November 6. 2018

Category : Darker Skin

Tuesday, November 6. 2018

Do Dermatologists still perform Chemical peels? YES TCA peel, Jessner peels, Glycolic peel, Phenol peel

Chemical peels

I have 30 different laser and light sources but still use a variety of chemical peels at my office.

Some patients don’t respond well to lasers and have a better experience with chemical peels.

Chemical peels are generally speaking milder and more superficial than lasers.

The drawback is that here is no heat (as is the case with lasers) and not a drastic tightening.

On the other hand certain conditions such as Melasma do respond better to a series of less invasive chemical peels.

We offer:

  1. Glycolic facial peels (10%, 20%, 30%, 50%, and 70%)
  2. TCA peels (Tri- Chlro-Acetic Acid) 10%, 20%, 30%, 50%
  3. Jessner peels
  4. Phenol  Peels

Glycolic peels are mild and basically have little to no downtime.

TCA and Jessner peels are considered medium depth peels and help with fine lines, discolorations, and sun spots such as Actinic and Seberrhoic Keratosis. Phenol peels are rarely done these days. It can be toxic to the kidneys and the healing time can be several weeks.

Lasers are much more effective and safer than Penol Peels. The reason for this is that lasers have a very predictable and controlable depth of penetration.

I always ask my patients about history of cold sores. When performing a medium or deep peel the patient may need to be pre-medicated with an antiviral medication such as Acyclovir.

Chemical peels can be combined with other procedures such as laser or Ultrasound tightening and more. Finally; chemical peels can be very affordable. Glycolic peels are $150 and full face TCA peels of face, neck, chest with sedation are between $1000-$1500

Come in for a complimentary consultation to see if you are a good candidate.

Please click under procedures and Chemical peels and rteview our before and after photos.

Yours,

Dr David Rahimi

323 653 7700

 

Friday, November 2. 2018

Category : Fat Transfer

Friday, November 2. 2018

Harvesting fat from lateral thighs or abdomen can leave unsightly dents; we can fix it

One of the problems I have encountered is that inexperienced surgeons often use large cannulas to harvest fat. This, in turn, can cause large and unsightly indentations that can be very difficult to reverse.

In this case my patient saw a surgeon for fat grafting to the face. Fat was harvested from the lateral thighs and injected to the face. The facial fat was lumpy (that is a different story) but the area from which the fat was harvested become indented and saggy. Many years later she is still hesitant to put on a bathy suite or be intimate with her partner.

Two or more sessions may be needed but ultimately these defects can be fixed.

Please come in for a consultation and allow us to help you.

 

Yours,

Dr David R.

323 653 7700

www.foreveryoung.net

www.westlakelaser.com

 

Thursday, October 11. 2018

Category : Darker Skin

Thursday, October 11. 2018

Scar-less mole removal; is it possible??

 

As a Dermatologist I see several patients a week who want to have their moles removed. Mole removal for a purely cosmetic reason is quite tricky and I spend a considerate amount of time educating my patients on this topic.

Pigmented moles or moles that have increased in size or changed color or bled need to be removed and examined under a microscope. We diagnose many basal cell cancers, squamous cell cancers and the occasional nodular melanoma this way.

However; most of my patients wish to remove their moles for purely aesthetic reasons. If the mole is skin colored it can be shaved off flush with the skin. No sutures are required and the scar is practically erased using a Co2 fractional laser.

Darker cosmetic and benign moles need to be cut and sutured to fully eliminate their roots. On the face this can leave an unsightly and largely unacceptable cosmetic result. I generally discourage my patients from having flat dark moles cut from their faces. The scars are usually worse than the mole.

I hope this was helpful to you.

Cosmetic Consultation is free and we would be happy to schedule an appointment for you

Yours,

Dr David Rahimi

323 653 7700

Thursday, March 29. 2018

Category : For Men

Thursday, March 29. 2018

Cosmetic Surgery for Men; our interview in playboy.com

Please read about Dr. David Rahimi's interview with Sean Arenas from Playboy.com

Cosmetic Surgery for men is no longer an absolute Taboo. Non surgical modalities and "no downtime" procedures are allowing men to look better with little or no downtime. The key is to look natural.

Please come in for a complimentary consultation

323 653 7700

Zonya Villatoro

Office manager


Dr. A. David Rahimi, lead surgeon at Forever Young in Los Angeles, has seen a dramatic increase in male patients in less than twenty years. “When I finished my training in 1999, maybe 5 percent of my patients were men,” he says. “Now, one-third of my patients are men.” Advances in surgical and nonsurgical techniques have made cosmetic enhancements more readily acceptable. “Twenty years ago, all we had available was cutting surgery,” he notes. “We now have many, many options to tighten up the skin, remove brown spots and fine lines, and make someone look healthier and younger.”

Dr. Rahimi, on the other hand, has a more conservative outlook. “More and more men will speak about receiving cosmetic surgery, but it’s still taboo because, unfortunately, some practitioners go overboard. They do a little and it looks good, so the patient asks for more. The [surgeon] agrees and they make the client look done or fake,” says Dr. Rahimi. “And I don’t think men are going to talk at parties with each other about getting Botox or fillers,” he adds. “It’ll always be something that they do but not readily admit to—but it’s becoming more acceptable in our society.”

 http://www.playboy.com/articles/men-cosmetic-surgery-aging

Tuesday, November 10. 2015

Category : Facelift / Tuliplift

Tuesday, November 10. 2015

Tuliplift™ - A surgical Facelift performed under local anethesia

Tuliplift™

Don't you wish there was a surgical facelift that could be performed entirely under local anesthesia??

In fact there is such a procedure and it was developed by Dr. David Rahimi about 17 years ago. It is called the Tuliplift™

http://www.foreveryoung.net/tulip-face-lift.html (click on our before and after videos)

www tuliplift.com

Since 1999 Dr. Rahimi has performed dozens of these Tuliplift™ procedures completely under local anesthesia and with quite impressive results. (Occasionally Dr. Rahimi also uses a little injectable pain medication, such as Demerol, or muscle relaxer to make the procedure more comfortable.)

Tuliplift™ addresses both the sagging of the tissue, volume loss, and sun damaged and discolored skin.

Here is how Dr. Rahimi himself explains the procedure: I start by removing about an inch of skin from the front of each ear. If you just remove the skin the results are temporarily and the skin stretches back within about 2 to 3 years. In order to ensure a long-lasting results the muscle and deeper tissues are also tightened with permanent sutures Fatty deposit from the neck and Jowl area is removed using laser liposuction. This is followed by tightening the neck muscles surgically. The harvested autologous fat is spun down and injected back into the nasolabial fold and cheek area. (As we age the bones of the cheek and chin resorb and the face falls. Fat is used to lift the cheekbones to their natural state) No drains are needed and a light dressing is removed the next day. Sutures are usually removed 7 to 10 days after the procedure and at that point in time Dr. David Rahimi performs a fractional Mixto CO2 laser to reduce the appearance of the surgical scars and also to remove brown spots on fine lines.

I am often asked why I don't use General Anesthesia to perform my Facelifts. The answer is quite simple: general anesthesia has far greater risks than local anesthesia and my patients understand and prefer this way of doing surgery.

 

 

 

Watch our videos on Youtube: ABC News spot from almost 15 years ago: https://www.youtube.com/watch?v=bJ2V2jFCKOQ

Another video: https://www.youtube.com/watch?v=qCT5CDPsCjU

 

 

 

Here is what is included in the Tuliplift:

-Consultation by Dr. David Rahimi -Removal of the fatty deposits under the chin using Laser Liposuction

-Tightening of the neck muscles (Platysmoplasty)

-Liposuction of the Jowls

-Fat transfer into the nasolabial folds -Tightening of the muscle and underlying structures (not just skin)

-Removal of the excess skin from the side of the face and neck

-3 layers of sutures: permanent sutures are left in for long lasting results

-Sutures are removed 7-10 days after the procedure

Above fees are all inclusive and include OR Fee, Surgical Fee, Doctors Fee, Blood work, and all follow ups. Please call us for a complimentary evaluation. Zonya Villatoro – office manager

Dr. A. David Rahimi, MD,FAAD,FAACS.

Friday, February 14. 2014

Category : Fat Transfer

Friday, February 14. 2014

Another Death due to unlicensed facialist doing facial surgery in a mall!

Vampire lift by a facialist leads to patient death. 

A woman who died this week after going into cardiac arrest at a beauty salon had undergone a cosmetic medical procedure that involved a part of her body being "augmented by injection," Long Beach police said.

Long Beach police said that on Wednesday at about 12:20 p.m. they were called to Areli's Beauty Salon in the 2100 block of Pacific Avenue because someone was in cardiac arrest "under suspicious circumstances."

Authorities allege that 45-year-old Sandra Perez Gonzalez was renting space in the salon under the pretense of giving massages, but instead provided butt and lip augmentation and "vampire face lifts" -- a procedure in which a person's own blood cells are injected into their face -- without a license.

Authorities were first told that the woman who died, 36-year-old Hamilet Suarez of Long Beach, had come in for a massage but had medical issues before her session began. Detectives said they later uncovered that Gonzalez had been renting a room not just for massages, but for other purposes as well.

"We can confirm that the female who did pass ... did receive a cosmetic medical procedure ... in getting a certain part of her body augmented by injection," police Sgt. Megan Zabel told KTLA-TV.

It was not immediately clear which procedure Suarez received.

Gonzalez was arrested at 12:30 p.m. Thursday -- a day after Suarez died -- in the 2100 block of Pine Avenue for possession of controlled substances.

Gonzalez is only a licensed massage therapist and is not legally allowed to perform any of the cosmetic procedures she is accused of or administer any of the controlled substances that were found in her room, police said.

Twitter: @aribloomekatz | Facebook



http://www.latimes.com/local/lanow/la-me-ln-vampire-facelift-long-beach-woman-arrested-20140214,0,2242844.story#ixzz2tJIAxiJi

Tuesday, January 28. 2014

Category : For Men

Tuesday, January 28. 2014

Cosmetic Surgery for men- 2014

My Dermatology Residency in New York (Mount Sinai University) and the ensuing Cosmetic Surgery fellowship in California was quite broad . I graduated in 1999 and became versed in a variety of procedures including face and neck lifts, liposuction, fat transfer and laser surgery. At that time men accounted for only 1-2% of my patients and my experience with cosmetic surgery in men was very limited. Much has changed in the past 15 years.

 

Men now constitute about 25% of my aesthetic clients. The last Great Recession and a variety of other social and socio-economic factors have resulted in Americans working into their 70s and even 80s. My male patients fall into 2 main categories: Young men in their 30s and 40s with Acne scarring and older distinguished professionals into their 60s, 70s, and even 80s. The treatment of Acne scarring has significantly progressed. The advent of fractional CO2 lasers, Subcisions and more has allowed these patients to significantly and safely reduce their scarring. http://www.foreveryoung.net/acne-scarring.html

 

 

My older patients are contemplating cosmetic surgery for a variety of reasons. One that stands out again and again is to excel in their profession career. Unfortunately discrimination against older individuals is rampant in many industries. Older men are not regarded as cutting edge or up to date with the newest technologies. Many of my clients work with or even lead a team of much younger men and women. They feel that their age and “Aging” is starting to be a handicap and want to do something about it. For these particular reasons I have developed the concept and technique of “Quadrafecta”. http://www.quadrafecta.com/

As a Dermatologist and Cosmetic Surgeon I have various tools to tighten and lift the skin, fill in depressed scars and hollowness under the eyes, jawline and more, resurface sun damaged skin, remove excess fat in the jowl and neck area, and replace the lost Collagen. With over 20 laser and light sources at my disposal I can chose and pick to see what combination is best for my patients. I can then perform them all in one visit and under local anesthesia. This is a partial list of options available to me:

Ultherapy (Ulthera)- Ultrasound deep Face, eye and neck lift

Pelleve- superficial Radiofrequency face and neck lift

Mixto Laser _ Co2 fractional laser for fine and deep lines

Fillers- Sculptra, Radiesse, Juvederm, Restylane, Perlane

Chemical Peels- TCA and Jessner Peels

Smartlipo Triplex- fat removal and skin tightening with Smartlipo Laser

IPL Photofacial- Light source to remove brown spots and Blood Vessels

Diolite Laser- Laser to remove larger blood vessels

COOltouch Laser- Non ablative laser to tighten pores

Clear and Brilliant Laser- to remove fine line and brown spots

Thermage CPT- Body lifting with Radiofrequency

Relume- Removal of light scars with focused UVB light

YAG 5 laser- Removal of discoloration and irregular pigmentation

Using the most up to date technology and the power of combining different modalities has allowed me to achieve long lasting results that appear natural. All these procedures can be performed under local anesthesia and mild sedation and require little downtime. Looking natural is of paramount importance to my male patients. Choosing non-surgical lifts and lasers can achieve these goals. Please contact me for a free and confidential consultation.

Yours,

Dr. A. David Rahimi

 

Wednesday, March 6. 2013

Category : Darker Skin

Wednesday, March 6. 2013

Acne Scarring: We offer 3 Lasers; 3 Wavelenghts.

In addition to Mixto fractional co2 laser wi have 2 other wavelengh lasers for the treatment of active acne and acne scarring.

Comparison of a 1450-nm diode laser and a 1320-nm Nd:YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study.

Source

Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA.

Abstract

BACKGROUND:

Atrophic scar revision techniques, although numerous, have been hampered by inadequate clinical responses and prolonged postoperative recovery periods. Nonablative laser treatment has been shown to effect significant dermal collagen remodeling with minimal posttreatment sequelae. Although many studies have been published regarding the effectiveness of these nonablative lasers on rhytides, there are limited data demonstrating their specific effects on atrophic scars.

OBJECTIVE:

To evaluate and compare the efficacy and safety of long-pulsed 1320-nm Nd:YAG and 1450-nm diode lasers in the treatment of atrophic facial scarring.

METHODS:

A series of 20 patients (skin phototypes I-V) with mild to moderate atrophic facial acne scars randomly received three successive monthly treatments with a long-pulsed 1320-nm Nd:YAG laser on one facial half and a long-pulsed 1450-nm diode laser on the contralateral facial half. Patients were evaluated using digital photography and three-dimensional in vivo microtopography measurements at each treatment visit and at 1, 3, 6, and 12 months postoperatively. Histologic evaluations of cutaneous biopsies obtained before treatment, immediately after the first treatment, and at 1, 3, 6, and 12 months after the third treatment were performed. Clinical assessment scores were determined at each treatment session and follow-up visit. Patient satisfaction surveys were obtained at the end of the study.

RESULTS:

Mild to moderate clinical improvement was observed after the series of three treatments in the majority of patients studied. Patient satisfaction scores and in vivo microtopography measurements paralleled the photographic and histopathologic changes seen. Side effects of treatment were limited to mild transient erythema, edema, and hyperpigmentation. No scarring or adverse textural changes resulted from the use of either laser system.

CONCLUSIONS:

Nonablative long-pulsed 1320-nm Nd:YAG and 1450-nm diode lasers each offer clinical improvement for patients with atrophic scarring without significant side effects or complications. The 1450-nm diode laser showed greater clinical scar response at the parameters studied. The use of nonablative laser systems is a good treatment alternative for patients with atrophic scarring who are unable or unwilling to endure the prolonged postoperative recovery process associated with ablative laser skin resurfacing procedures.

PMID:
14756642
[PubMed - indexed for MEDLINE]

Category : Lipolysis / Liposuction

Wednesday, March 6. 2013

Smart Lipo at Forever Young, Inc.

We are now offering Smart Lipo laser treatments for as low as $2500!

Upper and lower abdomen and flanks are usually $7000. For a limited time we can offer Smartlipo of the abdomen and flanks for $5000. This includes blood work, Garment and light oral sedation. Please contact us for a free consultaion.

http://www.smartlipocynosure.com/

Why Smartlipo Triplex™?

Tighter Skin

Smartlipo Triplex™ allows more complete melting of the fat using advanced MultiPlex (MPX) laser techniques, in which two wavelengths of laser energy are used for not only superior sculpting of the fat, but also, the biggest advancement in liposuction surgery-skin tightening. The MPX Smartlipo Triplex™ is unique in that it gives Dr. Petti the opportunity to focus on skin tightening following fat reduction, and this produces smoother, more natural and superior aesthetic results.

Minimal Recovery Time

Smartlipo Triplex™ can be done under local anesthesia, and therefore patients are ambulatory following the procedure, with no downtime. In fact, it would be more accurate to describe Smartlipo Triplex™ under local anesthesia, as being associated with "up" time! This has been very rewarding for the patients, Dr. Petti and her staff.

Minimally Invasive

The Smartlipo Triplex™ is a minimally-invasive laser surgical technique, performed by using a smaller-than-a-fine-point-pen fiber optic laser. Therefore, the entry points in the skin are very small and leave an inconspicuous scar. The laser wavelengths close down the blood vessels, so the result is associated with not only minimal surgical trauma, but also minimal bruising, swelling and resultant quick recovery. There is minimal discomfort, and Dr. Petti's patients often tell her that they did not need to take any pain medications the evening of surgery. The Smartlipo Triplex™ patients that have local anesthesia can drive the next day if they are off of pain medications, and can return to their normal daily activities in one to two days after surgery, depending on each individual patient.

Dr. Petti and her patients live by her motto, "What a difference a day of Smartlipo Triplex™ can make!", since many of them are at or near their ideal body weight and have spent a lifetime dreaming of making the change that her Smartlipo Triplex™ procedure creates-in hours.

Targets Unwanted Pockets of Fat

Smartlipo Triplex™ can also be used to treat larger areas of fat accumulation, or multiple areas of fatty deposits. However, in these cases the patient may need to have general anesthesia. It is normal in these patients for the recovery to be longer. Some patients may prefer to have several areas treated at one surgical setting. These patients are done in her private, ambulatory plastic surgery center under the guidance and supervision of board-certified and experienced anesthesiologists.

A Journey Through Smartlipo Triplex™ MPX™

Monday, February 11. 2013

Category : Fat Transfer

Monday, February 11. 2013

Westlake Laser and Aesthetics

 
 
3825 East Thousand Oaks Blvd Suite R
Westlake Village , CA 91362
 
Spinning the fat using the Coleman centrifuge allows more dense and compacted  
fat to be placed deep into the dermis and lower epidermal layer. The fat is placed after subsicion
and using blunt-tipped 16 and 18 gauge Coleman needles.
A certain percentage of this living "Graft" will establish a micro-circulation and "take" after about 2 weeks.
 
 
 
About 60 cc of the patients blood are centrifuged using the Harvest System.
 
Recovery 3 days to 7 days
Cost: $1500 to $3500
A. David Rahimi,MD,FAAD,FAACS.

Wednesday, January 30. 2013

Category : Fat Transfer

Wednesday, January 30. 2013

Great Article in Huffington Post on Fat Transfer

Fat Injections More Popular Cosmetic Surgery Procedure Than Liposuction

 

PA | Posted: 28/01/2013 07:56 GMT | Updated: 28/01/2013 09:37 GMT

 

Fat injections have become more popular than liposuction, new figures show.

 

The number of women who are transferring fat from one part of the body, such as the hips or thighs, to areas that have lost plumpness through age, including the face or hands, has increased by 13% in just one year.

 

Meanwhile, the number of women who had lipo has reduced by 14%, according to data from the British Association of Aesthetic Plastic Surgeons (Baaps).

 

A total of 2,641 women underwent a "fat transfer" procedure last year, making it the seventh most popular cosmetic surgery conducted by Baaps members.

 

Meanwhile, liposuction has dropped to eighth place.

 

Even though anti-ageing procedures are becoming increasingly popular, boob jobs still top the charts for the most common cosmetic surgeries - almost 10,000 women had breast augmentation in 2012.

 

LIKE HUFFPOST UK LIFESTYLE ON FACEBOOK | FOLLOW US ON TWITTER

 

Of the 43,172 surgical procedures carried out by Baaps members last year, one in 10 were conducted on men.

 

The most popular procedures for men were nose jobs, eyelid surgery and breast reduction.

 

Rajiv Grover, consultant plastic surgeon and Baaps president, said: "The growth rates for surgical facelifting and other anti-ageing procedures showed a double-digit rise, despite a double-dip recession.

 

"Interestingly, for the first time we see a greater number of women having procedures to re-insert fat - known as fat transfer, to add volume to the face - than to remove it, in the form of liposuction."

 

Thank you

A. David Rahimi,MD,FAAD,FAACS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thursday, September 6. 2012

Category : Procedures

Thursday, September 6. 2012

Proud to be a Pinpont Laser Platinum Provider

certified office
Dr. A. David Rahimi
Patient's Guide
Platinum Office

PinPointe FootLaser Expert

Cynosure's PinPointe Laser is the new gold standard for treatment of nail fungus. Cynosure is a leader in aesthetic medicine with lasers to address concerns ranging from getting rid of tattoos to removal of brown spots.

please click on the following link:

 http://clip2net.com/s/2hbYt

certified office

Wednesday, August 29. 2012

Category : For Men

Wednesday, August 29. 2012

Belly Fat- Great article in LA Times

Please read about Laser Liposuction and our non- invasive Zeltiq (coolsculpting ) procedures...

 

When belly fat is a worry

There are two types, and one is associated with health risks. Here's how to get rid of it.

  • Email
    Share
The belly fat blues

The belly fat blues. (Jose J. Santos / Los Angeles Times / August 25, 2012)

Belly fat seems so simple. Eat too many deep-fried mozzarella sticks while thinking about maybe possibly going to the gym someday, and your belly will eventually start growing. Nothing complicated about that.

But there's a lot going on beneath our over-stretched shirts. Scientists say that belly fat is strangely complex and widely misunderstood. If you want to do something about the bulge, you should know that slimming down can be complicated too.

"How you lose fat may be just as important as how much fat you lose," says Dr. Samuel Klein, professor of medicine and nutritional science at Washington University School of Medicine.

Belly fat is worth taking seriously. Doctors have known for a long time that a big midsection is a strong — but imperfect—warning of potential health problems such as heart disease and diabetes. "If you see someone with a big belly, that's a person who is probably at higher risk," Klein says. "Someone who just has a big butt probably has less risk."

It's important to realize that belly fat isn't created equal. Much of the fat in the stomach area lies directly under the skin. This so-called subcutaneous fat can really weigh you down. But as far as scientists can tell, it doesn't seem especially hazardous to your health. Klein led a 2004 study showing that patients could instantly lose 30 pounds or more of subcutaneous fat through liposuction without seeing any of the health benefits normally associated with weight loss, such as lower blood pressure, lower cholesterol and greater sensitivity to insulin.

When it comes to health, fat under the skin seems to be far less important than fat that wraps around the internal organs, also known as visceral fat. "Visceral fat is linked to diabetes and cardiovascular problems even more than BMI," or body mass index, says Dr. Steven Grinspoon, professor of medicine at Harvard Medical School and director of the program in nutritional metabolism at Massachusetts General Hospital. Nobody knows why visceral fat seems so risky. One possibility, according to Grinspoon, is that it may cause harmful inflammation.

But Klein believes that visceral fat may just be a side effect of an unhealthy lifestyle, not a direct threat. He adds that about one out of four obese people seems to have perfectly fine cholesterol, blood pressure and insulin sensitivity, as if all of that fat didn't really matter. You can't know for sure if a large-bellied person is on the road to health problems without a battery of tests, he says.

Most people who have a lot of obvious belly fat also have a lot of visceral fat, Klein says. And usually vice versa. He suggests a test that should be tried only on close acquaintances (or possibly yourself). "If someone has a big belly, just try to pinch it. If you can get a big chunk, they have a lot of subcutaneous fat. If you can't, it's probably mostly visceral fat."

Visceral fat lies beyond the reach of any suction tube. If you want to rid yourself of this possible risk factor for heart disease and diabetes, you'll have to take another approach. One proven formula, Klein says: cutting calories and getting more exercise. When people slim down through diet and exercise, visceral fat disappears twice as fast as subcutaneous fat, he says.

If you want to quickly trim your waistline without surgery, you might consider a noninvasive "body shaping" procedure. Plastic surgeons, for example, can use high-intensity ultrasound to destroy fat cells, tighten the collagen in the skin and remove a couple of inches from the waist — not enough for the outside world to notice, maybe, but enough to make a difference. "Patients often say that their pants fit better," says Dr. Mark Jewell, a plastic surgeon in Eugene, Ore., and a past president of the American Society for Aesthetic Plastic Surgery.

Unfortunately, such noninvasive approaches are financially out of reach for many Americans. And if a person has too much belly fat, Jewell says, the ultrasound waves won't be able to reach deep enough to do much good. Almost all patients with a BMI over 30 need to slim down before getting the procedure. "I sometimes send them back to a personal trainer," Jewell says.

health@latimes.com

Wednesday, August 15. 2012