Paul J. Weber, M.D., P.A.

With regards to liposuction, did you know: That liposuction was invented by an Italian gynecologist? Plastic Surgeons did NOT invent liposuction. That the Florida Board of Medicine Data Bank and studies show that Board-Certified Plastic Surgeons, even after adjusting for numbers of cases done, have the highest mortality rate of any surgical/medical specialty group practicing the liposuction. That there are many different ways liposuction can be performed? Did you know that of all the different specialties of doctors studied that perform liposuction, Dermatologic Surgeons have the lowest problem rate as shown by both insurance industry publications, the published medical literature and the Florida Board of Medicine Data Bank.

Dr. Weber specializes in the Tumescent Method of liposuction, seen in 1996 on national evening shows like Dateline and ABC News 20/20. (EVEN THE PROMINENT PLASTIC SURGEONS INTERVIEWED ON THIS SEGMENT AGREED THAT THE KLEIN METHOD WAS THE SAFEST AND THE BEST). These television shows interviewed Dr. Klein, a California dermatologist who wrote the book on anesthetics and liposuction. In the late 1980's, Dr. Klein invented the tumescent technique. Dr. Weber was among the first doctors in the United States trained in the Klein method. Dr. Weber was trained in the Klein method not long after it was invented, during residency training. According to numerous studies, this tumescent technique of liposuction provides the highest patient satisfaction, greatest patient safety, least bleeding, and quickest return to work possible. Bleeding is minimal. Patients often lose more blood from a blood test than they do from the tumescent technique. Dr. Weber is well-published in the medical journals on topics including liposuction. Dr. Weber also developed the continuous lumen~ cannula system which was manufactured by Reliance Medical Inc. Dr. Weber also developed the motorized rotary liposuction cannula system known as STARS currently manufactured by KMI, inc.

	TRADITIONAL LIPOSUCTION (also includes the wet method)	TUMESCENT METHOD AND VARIATIONS INCLUDING HYDROLIPOSCULPTURE	GENERATIONS I & II of ULTRASONIC LIPOSUCTION (Internal Type; Generations I & II, still unfortunately see use.	III GENERATION ULTRASONIC LIPOSUCTION Please see Chapter 33 - Three Generations of Ultrasonic for information on Generation III) at www.lipoinfo.com
PAIN CONTROL	Usually general anesthesia - gas, sometimes IV sedation.	Local anesthetic (numbing)+/-IV sedation. Occasionally general in special mild combination(see anesthesia chapter).	General or local	General or local
COST	Expensive	Variable but usually with cost savings if in office based.	Expensive. Still in wide use, as conversion to newer equipment is very costly for doctors.	Expensive only 100 - 200 units in the U.S. now
RISKS	Higher complication rate	Lowest rate of complications documented in the medical literature. Greatest patient satisfaction documented in the medical literature	Vibrations weaken cannulae. Cannulae breaking into pieces inside of patients has been reported. Perforations of kidney and gallbladder have occurred. "End hits" and seroma formation. Cannulae are moved slowly. Burning hot cannula tip may cause long-lasting nerve damage, seromas.	Significant improvement over generations I & II. Safe only in experienced hands.
EXPECTATIONS	Moderate improvement	Desired improvement with greater proven safety.	Large bulky cannulae cannot be bent to create a customized approach.	Best when used as part of hydroliposculpture.
BLEEDING	Significant blood loss often requiring transfusion	Minimal blood loss, a patient usually loses more blood during a blood test than with these procedures.	Varies with method of numbing, general or local.	Minimal when used as part of hydroliposculpture.
LENGTH OF SORENESS	NO long-lasting pain relief. Requires immediate and significant pain-killers after surgery.	Long-lasting pain relief up to 24 hours following surgery. Usually only minimal oral analgesia needed to ease discomfort.	Varies with method of numbing, general, local, tumescent or wet methods.	Same as tumescent when used as part of hydroliposculpture.
IV FLUID NEEDS	NOT a tumescent technique, misleading if stated so. Need IV fluids to replace what is lost	As seen on Dateline and 20/20 news shows. The replacing fluid has already been in the patient in the form of the Tumescent Solution. No extra IV fluids are needed.	Variable.	Same as tumescent when used as part of hydroliposculpture.
RECUPERATION	Easier on surgeon's schedule, possibly harder on patient's recuperation	Faster recuperation time, walk-in-walk-out surgery may be done as an in-office procedure	Variable.	Same as tumescent when used as part of hydroliposculpture.
RETURN TO WORK	Return to work in days to weeks.	Usually can return to work the next 1-4 days depending on the treatment size.	Depending on cannulae size, usually days to weeks.	Same as tumescent when used as part of hydroliposculpture.
SPECIALISTS PRACTICING	Primary users: most plastic surgeons, some general surgeons	Primary users: Dermatological surgeons and Facial Plastic surgeons	Many liposuction experts are unimpressed with this method. A particular specialty gravitated.	Dermatologists, Plastic surgeons, Facial Plastic surgeons
INVENTING SPECIALTIES	Invented by Italian OB-GYNECOLOGIST	Invented by: Dermatologists	Several companies in development of machinery. Some out of business now.	Dr. Parisi (Italian)
SUCTION CANNULA SIZE	Larger instruments mean greater skin irregularities	Smaller cannulae (instruments) leave minimal surface changes Hydroliposculpture variant (see section)	Complex cannulae currently available only in larger sizes. Cooling water circulation through the cannulae not perfected.	Larger - complex cooling fluid has been improved much over prior generations.
OPERATIVE SUITE	Usually hospitals; Sometimes surgical center; Less office based	Usually in an office suite. Sometimes in a surgical center. Can be performed in a hospital if desired. Should receive general anesthesia medicines.	Usually hospital; Sometime surgical center; Less office-based.	Usually hospital or surgical center; Less office-based.

PLEASE NOTE: When contacting Dr. Weber in the matter of Expert Witness Services via MedOpine L.L.C. please contact him directly either by phone or fax; numbers are listed below. Please DO NOT SEND any e-mail regarding expert witness services.