CHAPTER I

INTRODUCTION

Liposuction has become the most popular means of trimming down in a flash. Many

people considered it as the most effective way to lose weight. However, we believe that

undergoing in this type of surgery does not guarantee that patients will always be satisfied with

the results. This procedure is risky and very dangerous. Surgical complications and side effects

might occur.

Why do people resort to this procedure? What are the possible health risks? Is there any

benefit we can get from it? This paper contains the viable answers that one may ask. First, we

will define liposuction, discuss about its brief history, and state some common reasons why

people undergo this procedure. We will also discuss its popular types: dry method, wet method,

tumescent, and ultrasonic liposuction; together with its potential problems and health risks.

Lastly, we will conclude our research through patronizing the natural means of slimming down.

This paper aims to inform that liposuction is not the best way to lose weight and not an

alternative for diet and manual exercise. Indeed, only people who are not obese and close to

being healthy are recommended to submit to this procedure.

CHAPTER II

REVIEW OF RELATED LITERATURE

“In cases where there are natural deformities or damage to one’s features caused by

accidents, it is necessary to undergo surgery to restore or improve not only one’s face but also to

boost one’s self-confidence and body image….while cosmetic surgery may enhance your looks,

[but it can’t be used as substitution for dieting and reducing weight] it certainly will not

guarantee that you will be the most popular person in town. [nor will it guarantee that it will be

a safe operation]. [Emphasis mine.] It may boost your self-confidence but true faith in one’s self

comes from within, not without.” ( Quirino C-4). Plastic surgery, specifically liposuction, can

improve one’s body appearance or restore it if ever the person’s physical appearance has been

changed and turned into an unwanted form. But surgeries such as this one can’t be used as a

substitute in weight reduction or dieting. In our research paper, we will be reporting what

liposuction really is, the reasons of people who undergo such surgery, its procedures, and its

effects to the body after the surgery. Although liposuction is a popular way of improving a

person’s body image, a person mustn’t assume that it’s also the best and easiest way. During the

surgery, there are possible complications that may happen such as infections. It’s a very delicate

and risky procedure that a person who’s planning on undergoing it must think carefully first

before deciding since there is no guarantee of it being successful.

2

“…there were no improvements in the…insulin sensitivity, lipid (cholesterol) levels,

blood pressure and other risk factors associated with heart diseases after liposuction…’Despite

removing large amount of subcutaneous fat, there were no beneficial medical effects, ( Klein B-

6). Through liposuction, we can change almost any part of the body. Other than new and good

shape of the body, this surgery does not show any more positive effects. As stated by Doctor

Klein, even with the removal of large amounts of fats, the body is still not safe from diseases

such as heart attack, high blood, etc. No other benefits are attained.

“Had they lost the same amount of fat by diet and exercise, we would have expected a

dramatic improvement in all parameters measured…. It’s not just how much fat you lose but how

you lose the fat is important.” (Klein B-6). Even if the person loses 20 kg of fat, it is almost

worthless if it’s just through surgery since it has been proven that liposuction doesn’t minimize

or remove any diseases caused by obesity. In a natural diet, fats are removed in the safest and

healthiest way. If someone would be asked to compare two previously obese people; one who

underwent liposuction and the other who exercised 5 times a week in a gym and eats vegetable

salads every day, which one do you think will get the most praise? The person who underwent

liposuction must have lost 20 pounds in one day but the other who had a diet plan lost 15 pounds

in 2 months. If you compare them through the amount of time and money used, surely the one

underwent liposuction will win. But if you compare them through amount of patience and

discipline, the one who exercised almost every day and ate diligently will surely win. Which

acknowledgement sounds better?

3

“Although liposuction is sometimes presented as a “permanent” solution in the sense

that fat cells are completely removed, if lifestyle isn’t changed and the cause of the fat is not

addressed, then remaining fat cells will grow in size and new fat cells can form.” (Burnthefat).

Losing fat in natural ways not only gives the person a health advantage, it also teaches discipline

and patience. One tries to resist the lifestyle he/she have gotten used so that he/she is able to

achieve his/her dreamed of weight measure. Liposuction only requires money and the bravery a

person has in taking a risky surgical procedure. Although the surgery can give one a quick

slimming down, the person cannot maintain being slim since he/she didn’t lose the desire to eat

the same amount of food he/used to eat.

4

CHAPTER III

METHODOLOGY

Liposuction is one of the newest cases in cosmetic surgery so there was a trouble in

finding books that contain the topic. Most of the sources are from the internet. Before using the

sources, it must be confirmed that the information posted is approved by a certified doctor since

it can’t always be assumed that what is posted on the net is true. The most reliable websites the

authors were able to use were: Drmelton, Lipoworld, Liposuction, Healthwise, Burnthefat, etc.

It has been confirmed that certified doctors have made reviews for the information posted on

those websites and that they have approved of the posted articles.

Topics like this can also be found in newspapers and articles. It is easier to look in the

vertical files of the library. Such articles can be found generally in Cosmetic Surgery.

Surveys are not advisable in this topic since liposuction is popular and used only by those

who could afford it so it can’t be assumed that the people to be asked had underwent the surgery

before. There will also be some problems concerning the questions included in the survey.

5

CHAPTER IV

PRESENTATION OF DATA AND ANALYSIS

4.1 Liposuction

This section defines what liposuction really is, its etymology and brief history.

4.1.1 Definition

Liposuction is technically from the Greek words “lipos” meaning fat and “suctio”

which means to suck (Tomanek). It is a medical process where in excessive amounts of

fat are removed through surgery. The desired body part such as face, arm, buttocks,

thighs, leg, breast, back and abdomen is sliced until the instrument used reaches the lower

portion of the dermis. Depending on the body area treated and the intensity of the

surgery, the patient can already perform ordinary task even if not yet fully recovered.

(Adam)

It is a common myth that Liposuction is the best way to lose weight. Based on the

article of Maria Essig, “The main purpose of liposuction is to reshape one or more areas

of your body, not to reduce body weight.” (Italics mine) The suctioning of deposited fat

within the skin is the method used to remodel body contours. Although undergoing the

procedure will make a person look thin, internal threats are unavoidable.

6

4.1.2 History

“THE IDEA OF REMOVING excess fat from localized body sites is not new”.

(lipoworld) According to Dr. Jeffrey Melton, the first attempt to remove fats was done by

a French surgeon, Charles Dujarrier in 1912. He used a “uterine curette” on the calves

and knees of a dancer which only brought excessive blood loss after hitting the femoral

artery of one leg. Unsuccessful surgeries followed after that attempt, not until in 1974

where Giorgio and Arpad Fischer began the first successful liposuction operation. Fischer

innovated the cannula connected to a suction which pulls the fat out of the subcutaneous

layer, causing less hematoma (blood clot) complication. (lipoworld)

Four years later, Illouz, a plastic surgeon, became interested and brought the

technique in Paris, France. Illouz and Fournier became partners and developed the “low

pressure vacuum suction” which enabled the cannula to remove more amounts of fat

(Melton). The liposuction procedure became popular that it reached the United States.

Laurence Field was the first American who learned the technique under Illouz’s tutelage.

Due to its increasing popularity, more American surgeons and dermatologists enrolled in

liposuction training courses of the “Core Surgical Curriculum in Dermatology” in 1987.

More complex procedures emerged as the number of health conscious individuals arise.

Such procedures are tumescent, ultra-sound assisted and laser-assisted liposuction.

7

4.2 Reasons for undergoing liposuction

Even with possible complications of the surgery, thousands of people still undergo

Liposuction every day. People undergo the surgery since (1) they want to improve their body

appearances and (2) they use it as a substitute for exercising and dieting.

4.2.1 Body Treatment

Mostly, women are the ones undergoing the surgery with this kind of reason since

they are more conscious with their looks. Through liposuction, fats are removed from

different parts of the body. People undergo the surgery since they want fatty bulges to be

removed so that their body shaping will look more appealing. Some also want to remove

fats from the inner thighs for a sexual function; slimming down the inner thighs allows

easy access to the vagina. This reason includes self-confidence. As it is stated at some

points, liposuction makes a person look better through its procedures. Some would feel

confident in almost everything they do because of their looks. They believe that looking

better is the key to self-confidence. Some undergo the surgery since they have

inappropriate bulges in the facial structure. The success rate of such facial surgery has a

high success rate but the patient must use thick make up if he/she does not want the scars

to be visible to others. Basically, people undergo liposuction to change and improve their

looks and appearances.

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4.2.2 Substitute for Exercise and Diet

There are those who believe that they can use liposuction as a substitute for

exercising and dieting. They assume that they don’t have time to exercise anymore because

of their jobs and obligations and that they can’t let go of the lifestyle they are living. People

tend to get impatient with the natural way of slimming down since it takes a lot of time and

hard work. It also takes weeks to lose a couple of pounds. While surgery only takes a couple

of hours and then your bulges are fixed. Although it is a much faster form of losing weight,

this is a very inappropriate reason for undergoing liposuction. As doctors say, liposuction

doesn’t really remove chances in getting certain illnesses that concerns obesity. It just

removes fat from the body and that’s it. It’s also a risky choice since, to perform such

procedure, areas to be treated are injected with anaesthesia. The wider the area to be treated,

the bigger the amount of anaesthesia will be injected which may result to overdose.

Exercising also contributes to a person’s health. Although it takes time before achieving the

desired fitness, it will be worth it since there is nothing at risk nor will complications occur.

9

4.3 Types of liposuction procedures

Liposuction is not just a process of sucking off fats through a sharp tube. It has many

types of processes including: (1) Dry Method, (2) Wet Method, (3) Tumescent Liposuction, and

(4) Ultrasonic Liposuction.

4.3.1 Dry Method

This is the oldest type of liposuction. This is the first type of liposuction ever

performed after the invention of the surgery. This method does not use fluid injections

hence this is the most painful procedure. The fats are removed from the body with little

pain control so it is performed with under general anaesthesia. This type removes only

small amounts of fat. This method once done, gives a big blood loss to the patient, much

bigger than the wet method. Those who underwent this type of surgery will not be able to

move much due to the serious pain the surgery has caused. This is a very life-threatening

condition since immobility could cause blood clots in the legs, which may break through

the blood stream and travel to the lungs, causing pulmonary embolism. Since this method

is quite known for its painful procedures and side effects, it is very rare for a surgeon to

use this type of surgery. If it is used, it is probably due to its small amount of payment

since only a few equipments were used in the process.

10

4.3.2 Wet Method

Before the surgery, an amount of fluid that consists of a solution of salt,

anaesthetic and adrenaline substances is injected. This is to make the blood vessels

contract. It is to be injected on the desired areas for surgery. With this technique, as

surgeons say, it is easier to remove fats than the dry method. Unlike the dry method, only

a few amount of blood are lost in this procedure. It is also less painful than the dry

method. The fluid injected lessens the bruising of certain areas in the patient’s body so

recovery takes only a few weeks or days. This is the same with some of the techniques.

An incision is made on the area of the skin then a tube is inserted to begin vacuuming the

fats. The only unique thing in this method is that the fluid injected is a special solution

that allows fat to be removed easier and faster. Even with this special fluid, pain and

possible complications still exist in the operation.

4.3.3 Tumescent liposuction

Tumescent liposuction uses a “local anaesthetic” to make the body part to be

suctioned numb. A large amount of a special anaesthetic drug called “Klein solution”

(composed of lidocaine, epinephrine and bicarbonate) is then injected to make the body

treated swell (Weber). The solution also triggers “vascoconstriction” or the contracting of

the blood vessels to reduce blood loss (Essig). The swelling of the area makes it easier

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for insertion of the small suctioning tube within the subcutaneous layer of the skin. This

handy tool called “cannula” allows fat to pass through its sharp end, going to the shaft

and to its handle. Accumulated fats are then stored in a vacuum pump or “aspirator”.

Normally, this method does not use a general anaesthesia.

Most surgeons agree that tumescent liposuction is the safest method of reducing

fat. Amount of blood loss is dramatically lessened from 40% to 1-3%.

“Lipoplasty experts seem to think that tumescent liposuction is the safest form of

liposculpture, although it is not free of all health risks or post-operative

complications.”(Bariatic) Possible complications might occur if the cannula is too large

and the amount of solution injected is greater than 35mg.

4.3.4 Ultrasonic liposuction

This method still uses the stainless cannula assisted by ultrasound equipment. The

high frequency vibrations created by the machine makes the fats break and fall from its

fibrous roots. Fats are liquefied through the sound waves produced. The surgery usually

takes 2 to 4 hours, which makes it more costly than the other procedures. Although

ultrasonic is a new form of liposuction, it poses more threats and complications such as

cell damage, swelling, nerve damages and organ defects if not properly used. This form

of liposuction only proves that a new breakthrough will not always have better results.

(Wikipedia)

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4.4 Problems encountered during the surgery

The easiest way of trimming down conceals negative effects on people. These are 1) cost

of the surgery and 2) complications and side effects

4.4.1 Cost of liposuction surgery

The cost if liposuction is somewhat the same with other forms of plastic surgery that

has three fees: “surgeon fees”, “anesthesia fees” and “facility fees.”

(Yourplasticsurgeonguide) Estimating the cost is dependent on the amount of body fat

removed. Other factors that affect the cost are the number or area of the body part treated, the

intensity of the surgical procedure and the time consumed. Normally, the cost of the surgery

will not be lesser than $3,000. The total amount can even reach $11,000 or almost half of a

million in peso. (Bariatic)

4.4.2 Complications and side effects

Although liposuction boasts unparalleled means of reducing fat effortlessly, this

procedure is extremely delicate and potentially life- threatening. Dr. Anderson of Harvard

Medical School confirmed that, “… the most effective option is liposuction, But it’s invasive.

The surgeon holes in the skin, insert a metal cannula and sucks out fat. Then there are risks

and complications, infection and scarring.” (Italics Mine)

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Complications are usually cause by unintentional mistakes or unskillfulness of a surgeon.

To illustrate, insertion of cannula in tumescent liposuction damages the tissues below the

dermis. (Curtis) Cannula with higher calibre would cause waviness or uneven skin surface.

The skin of the suctioned part has little bulges and lumpiness, unlike a normal skin with flat

and smooth surface. What happened is that too much fat is removed in the treated part or

there are some body fats left. Another factor is the elasticity of the skin. Patients who

experienced this complication are most likely not properly evaluated by their surgeon.

Liposuctioning above 40 years of age would not be very effective since the skin has become

poorly elastic. (Joaquino)

Minor skin deformities or side effects such as bruising, swelling, pain and numbness can

be retreated and medicated by the surgeon. However, fatal complications like fluid and

blood loss, pulmonary embolism, pulmonary edema, infections and allergic reactions brought

by the surgery have limited possibility for recovery (Essig).

Pulmonary embolism is caused by clogging of the blood or fat in the bloodstream. These

blood and fat clot may pass through the lungs thus causing fluid buildup or pulmonary

edema. Another possible cause is that great amounts of fluid were injected into the body. On

the other hand, the probable cause of infections in the body is the puncture of a sensitive

organ while the patient is being treated in the abdomen. The intestines or the spleen has

punctures due to the improper insertion of the cannula. Allergic reactions may become worse

when it cause toxic reaction (lidocaine toxicity) in the body because of the injected solution.

Improper use of the instrument and lack of sanitation would also trigger infection. Finally,

the most dangerous complication is no other than death. (Essig)

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4.5 Failed Surgeries and Complains

4.5.1 NBI files several criminal charges against Vicky Belo for a failed operation

MANILA - The National Bureau of Investigation (NBI) on Thursday filed a string

of criminal complaints against celebrity cosmetic surgeon Victoria "Vicky" Belo and two

other doctors for a botched butt augmentation procedure.

The NBI filed before the Quezon City Prosecutor's Office the complaints of

estafa, reckless imprudence resulting in serious physical injuries, violation of the

National Internal Revenue Code and violation of Article 110 of the Consumer Act.

The bureau said estafa was filed against Belo and Doctors Ronaldo Cayetano and

Francis Decangchon for deceiving Josefina Norcio into paying P250, 000 for the butt

operation, which went wrong.

Forty-year-old Norcio suffered complications from 2 butt augmentation

procedures performed by Belo Medical Group doctors in 2003 and 2005.

The NBI said reckless imprudence was filed against Belo and the two doctors

because of the injury caused by the butt augmentation on the patient.

The other two complaints were filed because of the Belo Medical Group's failure

to issue official receipts to the victim and for the deceptive advertisement on its website

regarding butt augmentation and the use of hydrogel for cosmetic surgery procedures.

15

The NBI said that the website assures potential customers that the use of hydrogel

is safe because it is 95 percent water.

The bureau's investigators, however, said that any foreign object injected into a

human body is bound to cause injury. (Balita)

4.5.2 Anaesthetic solution maybe to blame

Another liposuction patient, Judy Fernandez, 47, had a different doctor but the

same outcome. Death records show her cause of death to be complications of liposuction

and cosmetic surgery.

"What I saw was really a horrifying scene," said Ruben Fernandez. "My wife was

spread open on the operating table still; she never made it out of the room; her extremities

were swollen almost twice her size."

Both women were from California and had a type of liposuction known as

"tumescent" in which the patient is infused with an anesthetic solution containing

lidocaine.

Researchers from New York City Poison Control looked at 48,527 New York

City death records and concluded four deaths were associated with tumescent liposuction

over a period from 1993 to 1998. The fifth was found in an unidentified state.

"We have no conclusive proof these patients died of lidocaine toxicity, but the

evidence is compelling that this is a possible contributor because we tried to look for

other reasons that they died," said Dr. Rama Rao, the study's author. (CNN)

16

4.5.3 Sono Bello patients complain on various surgical upshots

Sono Bello claims to be “the nation's fastest-growing body contouring clinic” and

“the world leader in minimally-invasive cosmetic technology.”

Kirkland dentist Teresa Yagi says she still has faint scars from the cosmetic

procedure she had done at Sono Bello more than a year ago. The photo facial treatment

was done at Sono Bello in Kirkland, using the pulse laser machine. Yagi got burns on the

forehead and her hands were scarred and blistered after the procedure.

An internal document obtained by the KING 5 Investigators identified the

surgeon as Karen Shaw, a Surgical Consultant Director. However, Shaw denies doing the

treatment, and Sono Bello denies the procedure was done in their leased space, which

they vacated when they moved to Bellevue. Sono Bello issued a statement from Chief

Medical Officer Dr. Thomas E. Garrison saying: "Sono Bello does not perform such

treatments, the treatment was not authorized by us and the equipment allegedly used was

not owned or operated by Sono Bello."

Sono Bello says they fired Shaw. But she was still there in March 2009, when

Pam Andersen of Puyallup asked Shaw to do liposuction on her. Although Andersen has

cancer and blood clot in the past, Shaw claimed that everything would turn out fine. But

days after the operation, Andersen got sick due to pain and fluid leakage from the

puncture wounds made by the liposuction tubes. When Sono Bello was questioned about

the claims in Andersen's packet, they answered that the equipment used were

"unauthorized"... "not sanctioned or approved by Sono Bello." After weeks of recovery,

17

Andersen filed a complaint with the Office of the Attorney General Consumer Protection

Division against the medical company.

One month after Andersen had her liposuction, another Sono Bello patient, Aura

Javellana, was found dead. She died from lidocaine intoxication hours after a doctor

performed liposuction on her at Sono Bello in Bellevue. So fa,r no one has determined

that the doctor or Sono Bello did anything wrong, but it is suspected that there were

“unauthorized” materials used in the operation. (King 5)

4.5.4 Inquiry into liposuction death

Lauren James was aged 26 when she died three days after liposuction surgery. A

Melbourne Coroner says an inquiry into the death of a 26-year-old woman who died after

liposuction surgery will focus on her post-operative care. Lauren James died in January

2007 just three days after liposuction to her legs and buttocks.

Surgeon Tam Dieu told the Coroner's Court that he no longer performs

liposuction fearing his mental scars from Lauren James' death are too great to conduct

that type of surgery. Dr. Dieu told the court today that his liposuction was not to blame

for Ms James' death. He said he qualified in plastic surgery at Monash University and had

performed more than 200 liposuctions prior Ms James' death. He told the court the

operation itself was not at fault and Coroner Paresa Spanos said her investigation will

focus on the level of post-operative care. (ABC news)

18

CHAPTER V

CONCLUSIONS AND RECOMMENDATIONS

5.1 Conclusions

The general reason why people decide to undergo Liposuction is that they just

want to look good. No matter how painful or life-threatening the procedures are, some still take

the risk in undergoing the surgery. But do people really need to undergo such an operation just to

look good? They say that it’s okay as long as they have the money to pay for the operation. But

why not use the money to join a gym class? Exercise and have a healthy diet?

Liposuction is known to be the easiest and fastest way to change one’s body shape or to

slim down. But it is incorrect for a person to use it as a substitute for exercise and diet. As

doctors have agreed on, Liposuction is used only for reshaping one’s body, not a way to lose

weight. Not only is liposuction a painful hole in the wallet, it can also cause some permanent

damage to one’s outside and inner body.

If one is to take liposuction, a safe way is making sure that the surgeon has the proper

knowledge and skills that are needed in performing the operation since fatal mistakes are usually

cause by a surgeon’s error in his/her performance.

Doing it the natural way is the safest way to slim down. Although it may take some time,

it doesn’t have any health risks or any complications medical surgeries have. One shouldn’t

choose the easier and faster choices if it involves putting something valuable at risk.

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5.2 Recommendations

Here are a few recommendations in slimming down easier in the natural way.

5.2.1 Open your eyes

“The first step in adjusting any behaviour is becoming more aware of the habit

you want to change” (Foreyt). To do that, follow Foreyt's three-step programme: Weigh

in daily, record what you eat, and track your exercise. (Healthline)

5.2.2 All exercise counts

''Anything you do is good;'' (Brownell) Just by walking down the street can also

be considered as exercise since one burns fat while doing it. Walk if the bus station is just

a few blocks away. You can even walk your dog during the weekends if you have the

time.

5.2.3 Order the starters

“Begin meals with a broth-based soup or low-fat salad of no more than 150 calories,

and you'll eat less of the main course (Barbara Rolls)”. Foods like these are low in

calories yet high in proteins and fibre which the body needs the most.

20

5.2.4 Drink up

Studies show that for some it's easier to lose and maintain weight with meal replacements,

such as Slim-Fast or Ensure, than trying to estimate the calories in meals. (Healthline)

5.2.5 Eat more fruits and vegetables

Apple, bananas, oranges, cucumber, etc, eat more of them and make sure that they are not

covered in fats like sugar and salt. If possible, eat one in every meal. Remember, an apple a day

keeps the doctor away.

5.2.6 Start an early and big breakfast

Eating a big breakfast is a good way to start the day. It helps the person take control of his

eating the whole day. But eat what really matters. A full nutritious meal is the way to go. One

can’t expect to lose weight after having to eat doughnuts for breakfast.

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BIBLIOGRAPHY

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Feb. 2004: C-4

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<http://www.webmd.com/skin-beauty/liposuction>

Weber, Paul. “History of Liposuction”. June 2000. American Society for Dermatologic Survey.

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Tomanek, Martin. “Liposuction”. 14 Nov 2007. LaserPlastic Clinic. 16 Jan 2010

<http://www.drmelton.com/Chicago/Liposuction.html>

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of-liposuction.htm>

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Liposuction.htm>

“Cost of Liposuction Surgery”. 17 Jan 2010 <http://www.yourplasticsurgeryguide.

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com/liposuction/cost.htm>

Joaquino, James. “Common Complications in Liposuction: What can you do if you have them?”

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publicationSubCategoryId=111>

“NBI files several criminal charges against Vicky Belo for a failed operation”. Balita. 15 Feb

2010. < http://balita.ph/2009/11/05/nbi-files-several-criminal-charges-against-vicky-belo-for-a-

failed-operation/ >

“Liposuction”. Burnthefat . 20 Jan 2010. <http://www.burnthefat.com.htm>

“Liposuction”. Wikipedia. 8 Jan 2010. <http://www.wikipedia.org/liposuction>

Curtis, Patricia. “Fighting Fat”. Reader’s Digest. July 2007.

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 Melton, Jeffrey. “History of Liposuction”. Drmelton. 16 Jan 2010.

<http://www.drmelton.com/Chicago/Liposuction/History_of_Liposuction/history.html>

“Patient badly burned during cosmetic procedure”. King 5. 17 Nov 2009. <http://www.king5.com/health/liposuctionpart2-70325442.html >

“Inquiry into liposuction death”. ABC. 5 Nov 2009.

<http://www.abc.net.au/news/stories/2009/11/05/2734039.htm>

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