Liposuction

For centuries people have used various techniques to improve their physical appearance. In the late 1970’s Dr. Illouz, a physician from Italy, developed a technique to evacuate fat from targeted areas of the body called liposuction. In 1985 a Dermatologist from the United States introduced tumescent liposuction, which has revolutionized the way doctors now perform liposuction. Plastic Surgeons and other doctors have gradually learned from Dermatologists this superior technique. It permits liposuction procedure to be performed under local anesthesia rather than general anesthesia.

The Tumescent technique is recognized as the preferred form of liposuction because of minimal blood loss, a shorter post-operative recovery time, less associated pain, and unsurpassable cosmetic results. The old technique, still performed by many plastic surgeons, has severe risks, including the need for blood transfusions as a result of excessive blood loss and the risk of death during general anesthesia. Many cosmetic surgeons do not use the tumescent technique because it is more time consuming for the surgeon with the result that they can’t perform as many surgeries in a single day. Unfortunately, some doctors do not consider what is best for the patient to be their primary concern.

1. What is liposculpture or liposuction?

2. What areas can be treated by liposuction?

3. Who is a good candidate for liposuction?

4. Will the fat regrow after the liposuction procedure?

5. Is it the liposuction procedure dangerous?

6. Where is the liposuction surgery performed?

7. Who can perform a liposuction procedure?

8. What is the recovery like?

9. What happens with the excess skin after the procedure?

10. Will I have scars?

11. Can the liposuction procedure be repeated?

12. When will I notice results?

13. Will I lose weight?

14. What about ultrasonic assisted liposuction?

1. What is liposculpture or liposuction?

These two terms are synonymous for a surgical technique that selectively removes fat to improve the body’s contour. With the evolution of the tumescent technique, the size of the cannula (the tool inserted into the body) has progressively decreased, which has decreased the size of the skin incision (resulting in a smaller scar) and has created a more uniform removal of fat. A cannula is connected to a suction pump and inserted through a small incision in the skin. The cannulas extract fat in thin channels that result in a honeycomb pattern in the fat left in the body. After surgery, the channels collapse resulting in an improved body contour.

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2. What areas can be treated by liposuction?

In women the most commonly treated areas are the inner and outer thighs, abdomen, hips, knees, calves, ankles, arms, and chin/neck area. In men, the most commonly treated areas are the abdomen, flanks (love handles), chest, and neck/chin area.

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3. Who is a good candidate for liposuction?

The best candidates for liposuction are individuals who are exercising regularly and are near their ideal body weight. Usually they have a genetically inherited accumulation of fat that they find impossible to lose by diet or exercise and liposuction is the only realistic means of changing the body’s contour.

There are no definite age limit or weight limits for liposuction. Patients can be slightly or moderately overweight and still be candidates for liposuction. However, liposuction is not for the very obese and is not a substitute for weight loss. It is just as easy to gain weight after liposuction as it was before liposuction. In general, the most important thing is that the patient has a realistic expectation of what liposuction can achieve for them.

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4. Will the fat regrow after the liposuction procedure?

No new fat cells are produced following puberty; they just enlarge or shrink with changes in weight. Therefore fat cells that are removed by liposuction will not grow back. The improved body contour will be permanent as long as the patient does not gain excessive amounts of weight. However, if a patient gains excessive weight following liposuction, the fat will tend to accumulate in areas of the body that were not treated during the liposuction procedure.

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5. Is it the liposuction procedure dangerous?

As with any surgery, tumescent liposuction can result in minor side effects. He side effects can include temporary swelling, temporary numbness, and bruising. However, with the advent of the tumescent technique for liposuction, serious complications are almost non-existent.

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6. Where is the liposuction surgery performed?

With the advent of tumescent technique for liposuction and its decreased risks, the procedure no longer needs to be performed in the hospital. Recent statistics have shown that there are more complications when liposuction is performed in a hospital as apposed to in an out patient surgical center. There is also no need for hospitalization with the tumescent technique.

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7. Who can perform a liposuction procedure?

Dermatologists brought liposuction to the United States and revolutionized how liposuction is performed all over the world.

Dermatologists are trained in their residency programs on the proper the art of liposuction. However, any licensed physician can perform liposuction. Unfortunately, more and more plastic surgeons and other physicians with very little training are performing liposuction. It is of utmost importance to do your homework and look into the background of any physician before you allow them to perform your liposuction procedure.

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8. What is the recovery like?

Gauze bandages and special compression garments will be applies and need to be worn 24 hours a day for a minimum of five to seven days. For the next two the compression garments need only be worn during the day to achieve the best possible results. Recovery time varies from patient to patient. Most patients are able to return to work, golf, jogging, or aerobics within one to two days following surgery. However, a few patients take as long as one to two weeks to get back to their routine.

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9. What happens with the excess skin after the procedure?

Skin is quite elastic and has the amazing ability to retract and shrink to accommodate the new, small body frame (as is exemplified following pregnancy). There are a few patients with poor skin elasticity, who may opt to have the excess skin removed by surgery at a later date. However, this is quite rare and many patients thought in the years past to require a “tummy tuck” are now obtaining excellent results with strictly liposuction.

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10. Will I have scars?

Since cannulas used with tumescent liposuction are much smaller, the incision sites in the skin are also very small (no stitches are required) and the incision sites become almost unnoticeable with time.

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11. Can the liposuction procedure be repeated?

Yes, that is recommended rather than having a massive volume of fat removed during one liposuction procedure. Trying to remove every bit of fat may lead to unsightly irregularities and unevenness, which is very difficult or impossible to repair. The goal should be to achieve the most aesthetically pleasing result rather than maximizing fat removal. Liposuction can be repeated within 1 to 2 weeks, if a different site is being done. It is preferable to wait at least 3 months before performing a subsequent liposuction of the same body area.

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12. When will I notice results?

Patients usually see results within two to six weeks and improvements can continue for up to one year.

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13. Will I lose weight?

Once again, liposuction should not be used as a technique to loss weight; a more pleasing shape is the measure of success.

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14. What about ultrasonic assisted liposuction?

Recently internal and external ultrasound has been marketed as a new way to perform liposuction. This technique is a variant of tumescent liposuction. Internal ultrasound has more risks and no apparent benefit; therefore it should be avoided.

External ultrasonic assisted liposuction does not appear to produce any significant benefit over tumescent liposuction. Recently a very good “double-blind” study was performed comparing external ultrasonic assisted liposuction to tumescent technique. The results were there was no apparent benefit and there are increased risks when ultrasound was used.

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