Our Procedures

Dr. Altman performs a full range of cosmetic and plastic surgery procedures with the latest techniques.

Information regarding surgical procedures may be found on the American Society of Plastic Surgery Web site.

Dr. Altman may vary his techniques or have specific preferences relative to those techniques described on that Web site.

Specific inquiries may be directed to his email at Daipsc@aol.com

In addition to the many surgical procedures that we perform, there are a number of new services available in the office. These include:

Mission Statement Regarding Liposuction

In our hands, I believe the best technique for liposuction is to employ the services of a M.D. anesthesiologist for intravenous sedation of the patient coupled with the use of tumescent infiltration (local anesthesia) of the operative site. In addition to the surgeon (Dr. Altman) and the anesthesiologist, we have two registered nurses assigned to each patient. One assists Dr. Altman in the operating room. A second circulates in the operating room as an extra hand and is then assigned to the recovery room to help the patient through the process of completely waking up and getting ready to go home. There are two physicians and two nurses in the suite with the patient throughout the procedure and recovery.

The patient generally starts the procedure in the face down in the prone position so that the outer hips and outer thighs can be addressed. The anesthesiologist lightens the intravenous sedation so that they can voluntarily roll over to the face up position to finish the procedure. The anesthesia makes the patient very drowsy and relaxed, but they are not completely asleep. The degree of sedation can easily be titrated.

I do not believe that general anesthesia with patient's face down in particularly safe when other options are available. As a rule I do not use general anesthesia on the vast majority of my patients who undergo liposuction.

This has worked very well for us.

In some patients with very limited liposuction needs such as the outer hips and or thighs (i.e. a few hundred cc's only) we have successfully combined liposuction with breast augmentation merging two different anesthesia techniques. The patient starts face down under intravenous sedations (twilight sleep) for the liposuction. Once completed the patient rolls back to face up position on her own and then are put to sleep for the breast surgery. Our preference is not to combine procedures however, in a select group of young healthy individuals this has been completely successful.

I like to use the ultrasonic liposuction machine, but very conservatively. Usually it is not used more than 30 to 40 seconds per site whereas classical training might use it up to 5 or 10 minutes. The shorter interval seems to expedite freeing up the fat without as much risk of burning skin or surrounding tissue with this more aggressive instrument. I do not use ultrasonic liposuction on medial thighs or medial knees. It seems to be helpful for secondary procedures, males particularly for gynecomastia (breast tissue).

My philosophy is to perform liposuction with no more than 3000-cc removal per session. If more were needed then by definition in our office the procedure is staged. I generally limit the amount of fluid infiltrated to about 3000 c.c.s as well. Some of these decisions depend on the individual and the situation involved. It is not a procedure for weight loss. It is designed to sculpt small bulges in healthy people with "reasonably good skin tone." It is not a replacement for diet or exercise.

All-inclusive fees in my office for liposuction range from $5000.00 up to $7500.00, which include surgeon, anesthesiologist, lab work, medical clearance, and postoperative care. The number of operative sites does not determine the cost. If a second stage is necessary within 6 months to 1 year, it is generally in the range of $2000.00 to $3000.00

Surgery is performed in the Irvine Plastic Surgery Center, which is an upscale, private outpatient ambulatory surgical facility. Since the patients are only sedated but not put to sleep they generally recover quite quickly and are discharged to home within an hour.

Photos are available in our office upon request.

We welcome all new consultations at a charge of $50.00 per patient that will be applied to surgery should the patient decide to proceed.