Liposuction

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LIPOSUCTION of the Body

Diet and exercise can help shape, tone and firm the body. Unfortunately, the same diet and exercise may not address every area of the body. Genetics can be a contributing factor to the accumulation of fat in specific areas. Additionally, metabolism changes as we age, making it even more difficult than ever to rid ourselves of fat.  For many men and women, these localized pockets of fat can look disproportionate to other areas of the body, making it difficult to feel comfortable in clothes and resulting in low self-esteem.

Liposuction was originally designed to remove areas of fat primarily in the body, but is frequently performed on the face and neck as well.  This procedure can help to contour and sculpt the body by eliminating unwanted fat from specific areas including thighs, knees, abdomen, hips, waist, buttocks and upper arms.

Liposuction should not take the place of good nutrition and regular exercise. It should be used primarily to reduce stubborn areas of fat that have not responded to traditional exercise and weight loss.

Who is a candidate for liposuction?

• Men and women who wish to eliminate isolated pockets of fat that cause areas of the body to appear disproportionate.
• Some of the best results are seen on patients of normal weight with good, firm skin elasticity. Those with extremely loose or thin skin may require a different type procedure (lift or tuck) to correct their problem areas, as they may not achieve the best result through liposuction alone.
• Those wishing to create a more toned look by contouring and sculpting and shaping areas of the body.
• A good candidate will have realistic expectations about what liposuction can achieve for them and understand that a good nutritional program and exercise program following surgery is needed to maintain their results.
• Patients must be in good health.
• Age is not necessarily a factor but younger patients with tighter skin may achieve better results than an older patient whose skin is less firm. Candidates for liposuction should discuss expectations with their surgeon before making a decision.

The Procedure

Liposuction is performed using general anesthesia. Surgical time will vary with each individual patient by the number of areas on the body to address, the size of the patient and, amount of fat to be removed and the surgical technique used.

In liposuction, tiny incisions are made inconspicuously in and around the areas where fat is to be removed. Through these incisions, a cannula, narrow and tube-like, is inserted and used to extract fatty layers underneath the skin. The cannula is guided by the surgeon using back and forth motions to break up the fat cells and suction them out. The suction process is provided by a vacuum pump attached to the cannula.

During liposuction, fluid is also lost. These fluids are replaced with intravenous fluids during and after the procedure.

Fluid Injected Liposuction (Tumescent / Wet techniques)

Prior to the development of newer liposuction methods, the extraction of fat was performed without the “wet” or fluid injected technique. Surgery was performed without placing fluid in the body. This limited the amount of fat that could safely be removed due to bleeding. This technique also caused more bruising, swelling and pain.

Later, the fluid injecting techniques became more popular. Through this technique, a medicated solution is injected into fatty areas before the fat is removed. By injecting a fluid mixture containing a salt solution, an anesthetic known as Lidocaine (a local anesthetic) and Epinephrine (a drug that constricts blood vessels), surgeons were able to remove larger amounts of fat more safely and easily, resulting in less blood loss, bruising and pain. 

Large volumes of fluid are injected with the Tumescent technique. Sometimes the amount of fluid injected can be as much as three times the amount of fat to be removed.

Similar to the Tumescent technique is the Super Wet technique. With this method, less fluid is used and the amount of injected fluid is equal to the amount of fat to be removed.

Ultrasonic-Assisted Liposuction (UAL)

A technique whereby a special cannula is used that produces ultrasonic energy. A sound wave generator is attached to a sterile hand piece with a titanium rod that vibrates at a very high, slightly audible pitch. This sound wave creates energy into the fatty tissue causing this fat to break up and liquefy, making it easier to extract.  This technique causes less trauma to surrounding tissue, as it only requires low-pressure suctioning, making the procedure a bit gentler.

This technique has improved the ease and effectiveness of liposuction in fibrous areas of the body that were once more difficult such as the upper back and the enlarged male breast. Additionally, although the UAL method takes longer to perform than traditional liposuction, surgeons are able to remove larger amounts of fat with less blood loss.

Power-Assisted Liposuction (PAL)

PAL uses a motorized liposuction cannula that oscillates, vibrating back and forth to allow penetration of the tissue and greatly reduces the surgeon’s amount of physical exertion.  The PAL cannula is smaller, resulting in smaller scars and the surgery requires less time than other liposuction techniques.

This technique is also used in conjunction with the tumescent liposuction method and helps to facilitate removal of fat in more fibrous, difficult areas including upper abdomen, waist (love handles) and back.

How will I look and feel after surgery?

• Most patients can see a noticeable difference in their body shortly after surgery.
• You can expect residual fluid drainage from the incision sites during the first 24 hours.
• A tight, girdle-like, compression garment will be placed on you immediately following surgery to help control swelling. The garment will be worn for a few weeks.
• You will experience some discomfort, burning, swelling and temporary numbness after surgery. Pain medication prescribed by your physician will help to reduce this discomfort.
• Although you will feel sore and stiff for a few days, it is recommended that you start walking around as soon as possible to help prevent blood clots from forming in the legs and to reduce swelling.
• You will begin to notice more improvement after about four to six weeks, after most of the swelling has gone.

When can I get back to my everyday routine?

• The amount of time it takes for recovery varies greatly with each individual patient and is a gradual process.
• Most patients resume regular activities within a week or two but many patients are able to return to work within only days of their surgery.
• Stitches are usually removed within the first week
• Swelling and bruising will typically disappear within three weeks, but some swelling may continue to be present for six months or more.
• Strenuous activities should be avoided for about one month.
• You will begin to notice even more improvement in your shape and contour after about three months.

How long will my results last?

• Weight gain over time and age could alter your original results. Some patients come back for a secondary liposuction surgery, but the procedure should not be used as a weight-loss method.
• Scars are usually hidden from view and very minimal. However, liposuction can result in some irregularities of skin surface—waviness and unevenness—especially in an older patient with less elasticity and tone to the skin.
• Keep in mind that liposuction is used mainly to reduce volume. It will not improve cellulite, waviness or loose skin if you had these problems prior to surgery and may even worsen these conditions.
• The results of your liposuction procedure should last many years if patients continue a lifestyle of healthy eating and regular exercise in order to maintain your new body shape.

Liposuction can eliminate fat that accumulates in areas of the body to help create a more slender, proportional body shape and contour. The results can be dramatic and give patients the desired result they were looking to achieve. Liposuction can also improve self-esteem for many patients helping them to become more comfortable with themselves, their body in general and enabling them to fit into a variety of clothes more easily.

IT IS IMPORTANT TO NOTE

Liposuction is normally safe, as long as patients are carefully selected, the surgery center is accredited and properly equipped and the surgeon is adequately trained.

• There are risks associated with any surgical procedure.
• The specific risks and suitability of each procedure for a given individual can only be determined at the time of consultation. 
• Minor complications that do not affect the outcome may occasionally occur.
• Major complications are rare.
• Your plastic surgeon will review any and all risks and benefits with you during a private consultation.