Liposuction or Lipoplasty

Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as “lipoplasty” or “suction lipectomy,” has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping many plastic surgeons to provide selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don’t respond to traditional weight-loss methods.

If you’re considering liposuction, this will give you a basic understanding of the procedure — when it can help, how it is performed and how you might look and feel after surgery.

QUICK FACTS

IDEAL LIPOSUCTION CANDIDATE

Localized areas of excess fat
Good skin tone and elasticity
Within 10-20% of ideal body weight

LIPOSUCTION INCISIONS

Tiny, inconspicuous incisions

LIPOSUCTION TECHNIQUES

Classical liposuction
Suction Assisted Lipectomy (SAL)
Power assisted liposuction (PAL)
Ultrasound assisted liposuction (UAL), Laser assisted Liposuction, Radiofrequency assisted Liposuction

LIPOSUCTION STATISTICS

Length: 1 to 3 hours
Back to Work: 2 to 4 days
Return to Exercise:
7 days (light cardio),
3 weeks (more strenuous)

Am I a good candidate for liposuction?

To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. It’s important to understand that liposuction can enhance your appearance and self confidence, but it won’t necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas.

Any one or combination of the following conditions may indicate that you are a good candidate for liposuction surgery:

Areas of fat deposits that are out of proportion with the rest of your body and do not go away with diet and exercise – so called “diet resistant fat”.
Areas with minimal amounts of excess skin (Liposuction removes fat not skin) and good skin elasticity

Liposuction surgery may be considered to treat areas of excess fat in the stomach, buttocks, hips, love handles, saddlebags, thighs, calves, ankles, breasts (including gynecomastia), back, arms and neck.

Your Personal Consultation

During the initial consultation, you may be asked to point out exactly what you would like to see improved. A determination of the elasticity of the skin will also occur. Plans such as future pregnancies, etc. may be discussed. You should come to the consultation prepared to discuss your medical history including previous surgeries, past and present medical conditions, allergies and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems, diabetes, etc. should be reviewed as these medical conditions may increase some risks associated with surgery.

How Liposuction Surgery is Performed

The basic technique of liposuction involves the removal of fat via a hollow metal tube (cannula) that is passed through the fatty tissue. Individuals considering liposuction often feel a bit overwhelmed by the number of options and techniques being promoted today. In deciding which is the right treatment approach for you, your doctor will consider effectiveness, safety, cost and appropriateness for your needs. This is called surgical judgment, a skill that is developed through surgical training and experience. Your doctor also uses this judgement to prevent complications; to handle unexpected occurrences during surgery; and to treat complications when they occur.

Step one / fluid injection:
Tumescent fluid Injection (tumescent liposuction), a technique in which a medicated solution is injected into fatty areas before the fat is removed, is the commonly used technique. The fluid — a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) — helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.

Step two / fat aspiration:
One of the most common types of liposuction involves the aspiration of fat by attaching a pump that generates a vacuum. This is known as suction assisted liposuction (SAL).

In addition, a motor may be used on the cannula that causes the cannula to vacillate back and forth thus performing much of the “work” of liposuction know as power assisted liposuction (PAL).

An ultrasonic generator may produce sound waves above audible frequency that “breaks” the fat cells and the broken down fat is removed by SAL. Ultrasound assisted liposuction (UAL) has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast.

A laser or radiofrequency can also be employed to break down the fat cells. Each of the methods has advantages anddisadvantages.

These methods will be discussed with you at the time of the consultation. Additionally, the above techniques may be combined is some cases.

Your Liposuction Surgical Experience

The goal of your plastic surgeon and the entire staff is to make your surgical experience as easy and comfortable for you as possible. If you are a smoker, it is recommended to stop smoking well in advance of surgery since smoking can impair the healing process. Certain medications that increase the risk of bleeding such as Aspirin, non-steroidal anti-inflammatory medications, and some vitamins/homeopathic regimens should be discontinued before undergoing liposuction surgery. Your surgeon will provide you withadditional preoperative instructions. Liposuction surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for the next 24 hours. In some cases it is better that you remain hospitalized even for one night, usually for adequate pain control for the first 24 hours.

The Day of Liposuction Surgery

Your liposuction surgery may be performed in an accredited hospital and medications are administered for your comfort during the surgical procedure. Most frequently, local anesthesia and intravenous sedation are used for patients undergoing liposuction surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will most likely be wearing a compression garment, usually used to help “shrink” the skin. Concerning postoperative pain, many patients state that the area feels sore, as if they underwent a vigorous work out. You probably will be permitted to go home after a short period of observation, although some patients may stay overnight in the hospital or surgical facility.

Recovery from Liposuction Surgery

After surgery, you will likely experience some fluid drainage from the incisions. Occasionally, a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. To control swelling and to help your skin better fit its new contours, you may be fitted with a snug elastic garment to wear over the treated area for a few weeks. Your doctor may also prescribe antibiotics to prevent infection. Don’t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days. It is normal to feel a bit anxious or depressed in the days or weeks following surgery. However, this feeling will subside as you begin to look and feel better.

It is important to realize that the amount of time it takes for recovery varies greatly among individuals. The first few days after surgery, you should rest quietly. If you can elevate the body part, it is usually suggested that you do so. Remember, you must not take aspirin or certain anti-inflammatory medications. You most likely will wear a garment. If it is too tight you should promptly notify your surgeon. During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. The swelling persists longer. Bruising typically disappears within seven to ten days. Stitches are usually removed within a week of surgery. Straining, bending over and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within ten days or less.

Healing is a gradual process. Your surgeon will probably tell you to start walking around as soon as possible to reduce swelling and to help prevent blood clots from forming in your legs. You will begin to feel better after about a week or two and you should be back at work within a few days following your surgery. The stitches are removed or dissolve on their own within the first week to 10 days.

Activity that is more strenuous should be avoided for about a month as your body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more. Your surgeon will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed. If you have any unusual symptoms between visits — for example, heavy bleeding or a sudden increase in pain — or any questions about what you can and can’t do, call your doctor.

Liposuction Results

You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible. If your expectations are realistic, you will probably be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape. Liposuction surgery usually improves contours. In some instances it may be used in a circumferential fashion, thinning an area. Since the healing process is gradual, you should expect to wait at least several months to get an accurate picture of the results of your surgery. The small incisions used for access of the instrument known as a cannula, will fade over a number of months usually becoming barely visible. The results of liposuction surgery are usually long-lasting, but they may be affected by weight gain, aging, pregnancy and lifestyle factors.

Understanding Risks of Liposuction

Liposuction is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is adequately trained. As a minimum, your surgeon should have basic (core) accredited surgical training with special training in body contouring. Fortunately, significant complications from liposuction surgery are infrequent. Liposuction surgery is one of the two most common procedures performed by plastic surgeons. Most often this surgery is performed without experiencing any major problem. Some of the potential complications include hematoma (an accumulation of blood under the skin that may require removal), infection, changes in sensation, scarring, allergic reactions, damage to underlying structures, need for revisions, unsatisfactory results possibly necessitating additional procedures and medical risks. Other risks more specific to liposuction may include indentations and irregularities. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended. You can help minimize certain risks by following the advice and instructions of your plastic surgeon, both before and after your liposuction surgery.

Combined procedures

Liposuction can be performed as an isolated procedure, or in combination with other plastic surgery procedures. Liposuction may combined with abdominoplasty (tummy tuck), and can be added to a fat grafting procedure (autologous fat grafting, where fat cells are removed from one area of the body and transferred to another) used to smooth or fill lines and folds of the face or elsewhere on the body. Other facial rejuvenation procedures may also be combined with liposuction, and breast enhancement surgery may also be performed with liposuction as well.

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