Liposuction, also known as lipoplasty or liposculpture, is a body-sculpting procedure to remove fat deposits that are unresponsive to dieting and exercising. This procedure can be applied to many different areas of the body. Liposuction results in a slimmer and better proportioned figure.
In the abdomen, liposuction can be used alone to decrease flank fullness ("love-handles"), and decrease the thickness of the abdominal wall. Sometimes, it is used in conjunction with an abdominoplasty, or tummy tuck, to provide the patient with the best possible results. This mainly depends on the amount of excess skin and the quality of the skin in the abdomen, which will be evaluated during your initial consultation.
In the lower extremity, liposuction is often done to the outer thighs ("saddlebags"), to the inner thighs, to the buttock, and to the knee regions.
In the arms, liposuction is done commonly in the upper arm. Depending on the amount of skin laxity and skin tightness, this can sometimes be combined with a brachyplasty, or arm lift, for best results.
In the face, liposuction is used in decreasing the "double-chin" appearance.
Reasons for Considering Liposuction:
Liposuction versus Diet and Exercise:
Liposuction is not a replacement for proper exercise and diet. Patients that have excess weight will do better by starting with a professional diet regimen such as weight watchers® and with a regular exercise regimen. Once natural weight loss is achieved, which takes a number of months, liposuction can be used to address stubborn areas to complete the transformation.
How many areas can I have done?
Several areas can be liposuctioned on the same day. For your safety, we generally limit liposuction to approximately five liters of "aspirate". For some people, only one or two areas can be done before reaching this level, for others, four or five areas can be done. This all depends on the amount of preexisting fat in the region.
Who is a good Candidate for Liposuction?
Liposuction is a popular procedure for persons looking to improve their body contour by reshaping areas of excess fat. The best candidates are people looking to remove fat deposits resistant to diet and exercise.
Anesthesia:
Liposuction is generally done under general anesthesia or under intravenous sedation. When administered by a certified anesthesia provider, these techniques are very safe and provide patients with a comfortable experience. Smaller areas can be performed under local anesthesia only where the area is numbed and the patient remains awake. Make sure, however, that the provider offering to perform liposuction under local anesthesia in the office still has privileges to perform the procedure in a surgical facility under general or intravenous sedation. This will assure that he or she is recognized as qualified to perform the procedure by his or her peers.
Description of the Procedure:
Through tiny incisions in the skin, an infiltrating canula is inserted and "tumescent" fluid is infiltrated. This fluid consists of a mixture composed of lactated ringer's solution mixed with a local anesthetic (lidocaine), mixed with a constrictor of the blood vessels to decrease bleeding (epinephrine). The solution is massaged and given time to work. The amount of solution can differ between techniques ranging from a "super wet" technique where approximately the amount infiltrated is the same as the planned aspiration, to a "tumescent" technique where even more fluid is inserted. The technique used will depend somewhat on the amount of total aspiration planned and your body habitus.
After the infiltrate is given time to work, a narrow tube or “cannula” is inserted and used to vacuum out the fatty tissue beneath the skin. Different sizes of canulas with different lengths and apertures will be used according to each patient's fat location. The surgeon determines the amount of fat to be removed by massaging the skin and squeezing the tissue. After eliminating the excess fat, the incisions are closed
Compression:
A compression dressing or bandage is applied to the area and will need to be worn for an extended period of time (approximately six weeks). This will prevent bleeding, reduce swelling, and support the affected area. There are a variety of specialty garments manufacturers that provide specialized wear for liposuction patients.
Variations on Techniques:
There are several different types of "newer" liposuction procedures, such as ultrasonic and power assisted liposuction, that have developed as a result of recent advancements in new technologies. These are especially useful in targeting areas where the fat is more fibrous, such as in the back or breast. Together, the patient and the surgeon can discuss which method(s) are best during the initial consultation visit. Liposuction can last from thirty minutes to several hours depending upon the amount of fat to be removed. Liposuction surgery is an excellent procedure that can benefit those who want to remove unattractive fatty deposits.
Preparing for surgery
One month prior to surgery: it is recommended that any tobacco usage is stopped. Nicotine reduces circulation to the skin and subcutaneous tissues, impeding healing and increasing the chances of a postoperative complication
2 weeks prior to surgery: Stop all medications that can thin the blood at least 2 weeks prior to surgery. In your preoperative examination and workup, be sure to discuss with us any doctor prescribed blood thinners such as coumadin (warfarin), lovenox, or aspirin In addition, stop any over the counter medications and herbal remedies that may cause bleeding. For a list of these medications, please click here.
One week prior to surgery: Call our office to report any changes in your health that may affect your surgery such as recent colds or local skin infections. We may decide to postpone your procedure to maximize safety.
The day before Surgery: Do not eat or drink anything after midnight except for a small sip of water to swallow any blood pressure or heart medication pills. Shower with an antibacterial soap twice the day before surgery.
The day of surgery: Shower once more the morning of surgery with an antibacterial soap. Wear comfortable loose fitting clothes. Do not wear jewelry. Do take any blood pressure medications with a small sip of water.
Recovery Process
The length of the recovery will depend on how extensive of an operation the patient undergoes. A support garment may need to be worn for several weeks after the surgery, depending upon which area(s) are selected to utilize the liposuction procedure. Patients sometimes report minor pain associated with surgery which can be treated effectively with oral medication.
Post Operative Instructions:
Diet: start with liquids and some crackers. If those are tolerated, you may progress to a regular diet.
Driving: Do not drive for 3 days after your procedure or while taking pain medications that contain narcotics.
Activity: You may walk and climb stairs immediately after surgery. Make sure you walk about the house for at least fifteen minutes three times a day to decrease the risk of developing clots in the leg. After a month you may resume your excercise routine.
Work: Most people are able to return to work ten days after the procedure. Discuss your profession with us so that we may be able to give you a better estimate.
Wounds: there will be some fluid drainage from the incision sites for the first several days after surgery. Keep the incisions covered with a dry sterile dressing to catch the drainage.
Swelling: Moderate swelling and brusing is expected for the first several weeks. your elastic garnment will help minimize this.
Showering: you may shower the day after surgery. Pad your skin dry and apply new dressings if you do. do not submerge any incision site under water, but sprayed shower water is acceptable.
Medications: you will typically be placed on a short course of antibiotics and on pain medication. Resume your typical home medications except blood thinners, which you should restart only after discussing with your surgeon.
Call your doctor if you experience pain not relieved by the pain medication, bleeding, redness at the incisional sites, or high fevers.
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