LIPOSUCTION

WHO IS A CANDIDATE?

If you have excess subcutaneous fat, which is resistant to diet and exercise.

If you wish to change the contours of your body. Commonly involved areas are the anterior part of the neck (under the chin), upper arms and armpits, male chest/breasts, trunk, abdomen, waist, hips, thighs, inner knees, calves, and ankles.

Most patients are near normal weight and desire permanent contour changes. Patients with average weight, localized fat collections, and healthy elastic skin are the best candidates for liposuction. Obesity, cellulite, or loose, sagging, inelastic skin are several problems which would tend toward poor results. In face, these problems may be worsened by liposuction. Unfortunately, many individuals performing liposuction are not trained in other techniques of body contouring and may not have the experience to recognize that a different procedure (such as a tummy tuck) may provide a better result for the patient. Suction Assisted Lipectomy (SAL) may be used in conjunction with other body contouring procedures, such as breast reduction, tummy tuck, thigh lift, or face lift.

Improved techniques now allow larger amounts of fat removal. Liposculpture can be useful to heavier persons as well.

Suction Assisted Lipectomy (SAL) or liposuction is a surgical technique in which the removal of fat deposits reshapes a specific part of the body, such as the face, neck, arms, abdomen, hips, or thighs. Liposuction, which was actively practiced in Europe during the mid 1970's, was not popularized in the United States until the early 1980's. Since then, ft has become the most requested aesthetic surgical procedure. The popularity of this operation is based on its relative simplicity, which requires only a small incision, usually well-hidden in a normal fold of skin.

Frequently, patients seek liposuction to reduce their weight and general obesity. Unfortunately, liposuction is not indicated to treat these problems. Standard methods of weight reduction are required for these patients. Liposuction is intended to resculpt isolated collections of body fat that would not generally respond to diet and exercise; ft is a method of body contouring to reduce inches, not pounds. The good news is that the suctioned fat cells are permanently removed. If the patient gains weight later on, the new fat will be distributed in a more proportioned manner.

INTENDED RESULTS

A permanent improvement in the contour and proportion of the treated areas.

A more flattering figure or physique, in or out of clothing.

PROCEDURE DESCRIPTION

Liposuction can be performed in an outpatient setting, such as the surgeon's office or Surgicenter; less frequently a short hospitalization will be required. The procedure can last from 30 minutes to several hours, depending on how many body areas are being operated upon. The type of anesthesia will also vary. Local anesthetic with sedation can be used for small areas; however, more extensive procedures usually require general anesthesia. Through a small incision, usually less than one-half inch, a blunt-tipped instrument called a cannula is passed back and forth, essentially vacuuming out the fat. The cannula is connected to rubber tubing which in turn attaches to a machine which generates high vacuum pressure. Following surgery, a firm elasticized garment is used to provide compression and reduce swelling and discoloration at the surgical site.

During surgery, IV fluids are usually required to replace losses which occur with the procedure. Infrequently, a transfusion is required, but this can be anticipated prior to surgery so that the patient can receive his/her own blood (autologous donation).

If very large volumes of fat are to be removed, we will probably ask you to donate one or two units of blood and take supplemental iron before surgery. Your own blood will be used as a transfusion at the end of surgery.

RECUPERATION AND HEALING

As with all operations, pain and discomfort varies greatly from patient to patient. Generally, one should expect that pain medication will be required for the first several days. Continuing discomfort can last varying amounts of time. Much of the swelling and bruising will be improved by two weeks; however, some will persist for six to eight weeks. It is often difficult to see significant changes in the body shape before this time. It is frequently useful to wear an elastic garment for four to six weeks, to help with skin shrinkage. Your doctor will tell you how long you should wear your elastic garment. Normal activity may be resumed at 1-2 weeks, and exercise at 3-4 weeks. Your doctor will give you specific time periods during a post-operative visit. Persistent swelling and irregularities may be present for several months. If antibiotics are prescribed, they should be taken as directed.

OTHER OPTIONS

Additional procedures that may enhance the result are Tummy Tuck (Abdominoplasty), Breast Reduction, Breast Lift, Breast Augmentation, Thigh Lift, or Buttock Lift.

INSURANCE GUIDELINES

This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.

NOTE

IS HOSPITALIZATION NECESSARY?
Usually, hospitalization is not necessary. Many of these operations are performed under general anesthesia and may be done at a surgicenter as outpatient surgery.

IS THERE AN AGE LIMIT FOR THIS OPERATION?
People under 40 years of age usually get the very best results, because their skin is tighter. However, the state of the skin remains the determining factor.

ARE BANDAGES APPLIED?
As discussed earlier, compression garments are worn after the operation to assist in the retraction of the skin and to prevent swelling. Light massage is started on the 10th day. After the operation, exercises are recommended beginning on the 14th day, in order to minimize the adhesions between the skin and the deeper tissues. Early results are seen 10-14 days after surgery, but improvement continues for 4-6 months.

WHEN CAN YOU RETURN TO WORK?
In general, 3-5 days after the operation for office work, and 14 days for more active employment.

WHEN CAN YOU DO EXERCISES?
Usually, 2 weeks after the operation you may exercise, in order to modify and diminish the adhesions between the skin and the tissue. Walking, swimming, or a stationary bicycle can usually begin in a few days after surgery.

SHOULD YOU FOLLOW A SPECIAL DIET?
In order to have the best results, it is good to have a well-balanced diet, including carbohydrates, fruits, vegetables, and proteins, and not to overeat.

WHEN CAN YOU GET OUT IN THE SUN AGAIN?
When all the bruises have disappeared. This takes about 2-3 weeks. Use a sunscreen with a SPF of at least 15. Decreased sensation in the first few weeks or months after surgery may result in an accidental sunburn. Be careful.

ARE THE RESULTS PERMANENT?
In general, yes. If you gain a large amount of weight, however, the operated area will also increase but not as much as would have occurred before the operation. Rippling may also occur with large weight gain.

CAN THE OPERATION BE REPEATED?
Yes, in certain cases. It is preferable to operate in stages on heavier people.

WHAT ABOUT SCARS?
Following surgery, your surgical scars will go through a maturation process. For the first few months they will be red and possibly raised, firm or unsightly. As the scar matures, after 6-12 months, ft becomes soft, pale, and flat, and much less noticeable. You may experience numbness, tingling, burning, "crawling", or other peculiar sensations around the surgical area. This is a result of the healing of tiny fibers which are trapped in the scar. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent and unsightly with time. If you or a blood relative have a tendency to keloid formation, please inform me.

WHAT HAPPENS TO THE EXCESS SKIN?
Depending upon the age of the patient, the skin (because of its elasticity and retraction) will shrink over the reduced area of the body. Older or excess skin may require subsequent surgery to obtain the desired result.

WHY IS IT IMPORTANT TO HAVE PRE-OPERATIVE PICTURES TAKEN?
Pictures help in the analysis of the problem in pre-operative planning, as a guide during surgery, and in evaluating results. Consequently, they are necessary prior to all plastic surgery procedures.