The Innovator: Mr David Ross

By: Katharine Griffiths
Created on 09th February 2012

Who: Mr David Ross

What: UltraSculpt

Why: Smooth, taut contours without the trauma associated with lipo

In this series of articles, Cosmetic Surgery Today tells the story of the men and women who are pushing forward the boundaries of aesthetics. In this issue the spotlight is on Mr David Ross, who was one of the first UK surgeons to offer the revolutionary UltraSculpt treatment from Mentor

Liposuction is one of the most popular cosmetic surgical procedures in the UK, and these days there is a wealth of different techniques and brands of machine to choose from, but that hasn’t always been the case.

Back in the 1990s, the only widely used technique for fat removal was traditional suction- assisted lipoplasty, which although highly effective in the right hands, can cause a lot of trauma to the skin and is not suitable for treating smaller areas. There was at least one surgeon, however, who was offering ultrasound-assisted liposuction then, and whose patients were coming out with smoother, tautened contours as a result. Here, Mr David Ross explains why he was ahead of the pack.

CST: When was the first energy-assisted fat removal device invented?

DR: "Ultrasound-assisted lipoplasty as a device was developed in Italy in the late 1980s, but it wasn't really taken up by the rest of the world until some of our American colleagues picked up on it and started to develop it further in the US in the early to mid-1990s."

CST: What sort of testing was done to ensure its safety and efficacy?

DR: "It was particularly taken up by the McGann Corporation, who later became Allergan - makers of Botox - and they investigated it carefully under the supervision of the Food and Drug Administration (FDA).

"The surgeon performing the studies was a very eminent plastic surgeon in Nashville, Pat Maxwell, and he and his team were scrutinised by the FDA to see what the benefits and potential side effects of using this new technique were.

"There was a huge amount of interest in this study, partly because a lot of people saw it as a commercial threat, so a considerable degree of extra scrutiny was placed on it, to ensure it was going to be completely safe."

CST: When did you first come across the machine?

DR: "I saw the UltraSculpt machine for the first time in May 1996 and felt that this was a huge step forward.

"So I went home and told my colleagues at the London Clinic and another hospital I worked at and by the late 1990s we had three machines across those two sites. I've been using the machine now since 2000 and have built up an experience of several hundred cases."

CST: So what are the benefits of UltraSculpt from a patient's perspective?

DR: "Well, there is little doubt that you can remove a greater volume of fat than with normal liposuction, but with less blood loss.

"You also have a much lower incidence of causing divots, or troughs in the treatment area, because you are not relying on physical force to break down the fat, as you are with suction- assisted lipoplasty, but on an effect known as cavitation, where you're using the ultrasound to emulsify the fat into a liquid.

"Another important point is that the cannula that is used to harvest the fat is open at the tip, rather than the sides, and that means you can get much finer control - if you have a small area of residual fat, for example, with traditional liposuction it's extremely difficult to remove a small isolated lump. Whereas with UltraSculpt, because it's open tipped, you can take it right into the area of concern and break down that fat slowly and gently, so the soft tissue trauma is much less.

"Finally, there's the dermal tightening aspect. Traditional
liposuction removes the fat, but you might be left with a lot of loose skin, particularly on areas like the inner thighs, which is a very popular area for treatment. With ultrasound-assisted lipoplasty, however, if you wait six to nine months after surgery, you often find that most of that skin has tightened up and so there is no need for revision."

CST: You mentioned that UltraSculpt is useful for more challenging cases - can you give some examples?

DR: "Yes, it's very good for revision liposuction treatment, to improve upon poor previous results, and it's also useful to treat smaller areas, such as under the chin or the ankles.

"There is also a particular group of patients who have a very debilitating condition known as lipoedema, which is actually abnormal fat deposition. These patients are very slim from the waist up but have very wide hips, thighs, calves and ankles.

"With traditional, suction- assisted lipoplasty you would need several different operations to remove all that fat, because of the risk of blood loss and soft tissue damage, but with UltraSculpt you can safely remove up to 15 litres of fat in one surgical procedure.

"Another group is the male patient, where fat content tends to be more fibrous, and this procedure is particularly good for treating gynaecomastia, or male breast deformity.

"In almost 95 per cent of cases, I will treat the patient with UltraSculpt alone, and only a very small number of patients require secondary skin revision."

CST: Are there any special precautions that patients need to take before having an UltraSculpt treatment?

DR: "There are remarkably few contraindications - those that do exist are the same as for liposuction; you need to be physically well and you shouldn't see this as a weight loss treatment, but as an adjunct to a healthy lifestyle and exercise programme.

"There is no doubt in my mind that this should only be performed by a competent consultant plastic surgeon. The procedure is highly technique dependent and should not be used by anyone without adequate training."

CST: And finally, what are the considerations in terms of aftercare?

DR: "Any responsible physician offering this sort of surgery will also offer their patients very thorough post-operative support. Patients also need to wear a support garment for anywhere between four and six weeks, and we give them a graded exercise plan that takes them through their first three weeks."
CST