Liposuction (Fat Removal)
LIPOSUCTION (FAT REMOVAL)
INTRODUCTION OF LIPOSUCTION
Liposuction is a surgical fat removal procedure that first became popular in the 1980s. During the procedure, a board certified cosmetic surgeon carefully and precisely removes excess fat through a small, hollow tube called a cannula. Suction is applied as the surgeon moves the cannula through the fat deposit, removing excess fat cells and sculpting a slimmer body contour.
Liposuction is particularly effective at removing fat in the legs, abdomen, back, arms, face, and neck. It provides more dramatic results than other noninvasive fat reduction procedures, however, it has a longer recovery period (up to six weeks) and typically costs more than its nonsurgical counterparts.
INDICATION OF LIPOSUCTION
The indications for liposuction are:
- Removal of excess or unsightly fat deposits due to obesity
- Cases of ‘gynecomastia’ which refers to a condition of abnormal enlargement of breast in the male.
- A combination of abdominoplasty (tummy tuck) and liposuction can be done to achieve better results. Liposuction can be a part of breast reduction, breast augmentation, and facelift too.
TYPES OF LIPOSUCTION
Types- Liposuction is of two types:
- Tumescent liposuction
The Ultrasonic Assisted Liposuction (UAL) Surgery
In Ultrasound assisted liposuction ultrasound waves are used to liquefy the fat cells, which are then sucked out.
First, you arrive at the plastic surgeons office/surgi-center and are marked for surgery so the surgeon knows which areas to treat once you are on the table. Then, once on the table, you are injected with tumescent fluid. This mix is saline solution (water and salt) with a local anesthetic and epinephrine. This will help you to avoid extra fluid loss during fat extraction. Next, the ultrasonic waves are initiated, depending on whether you are receiving external UAL or internal UAL, and a high-pitched sound begins to liquefy the fat inside the specific body part until it loosens up enough to be sucked out of the body. This can either be done via a machine emitting the sound-waves into your fat tissue from outside the body (external UAL,) or via the cannula offering ultrasonic waves loosening fat within the body (internal UAL.)
Tumescent liposuction (super wet technique) uses large volumes of fluid, which is injected under the skin and helps in sucking out fat. Tumescent liposuction is considered by many cosmetic surgeons and patients to be the safest and most effective form of liposuction surgery. The use of larger amounts of local anesthetic not only reduces pain after surgery, but also reduces bleeding, swelling, and skin irregularities and makes the entire procedure run more smoothly.
Liposuction may be performed under local, regional, or general anaesthesia. No single anaesthesia technique has been proven to be superior over another. The technique of anaesthesia depends on both, the site and extent of liposuction and also patient preference. The anaesthetic technique will vary according to the areas being operated upon; arms, thighs, abdomen, or buttocks and the volume of liposuction being performed. Since these procedures are often performed as day care, it is important that there is fast recovery of psychomotor and cognitive functions ensuring early discharge of the patients.
PREOPERATIVE PROCEDURE OF LIPOSUCTION
- On the evening prior to the surgery, be sure to get a good night sleep. If needed, take the
- sedative (Valium) prescribed by Dr. Gross.
- On the day of surgery, limit food intake to light breakfast or lunch. Bring your prescriptions to
- the office when you come in for the procedure. Upon arriving to the office inform nurse. The
- Valium should be placed under the tongue when you arrive. Let the pill dissolve and then you
- may have some water.
- Be sure that your home and car will be prepared for you. Following surgery, drainage of
- tumescent anesthesia may ruin car upholstery, carpeting, linens, and bedding. We recommend
- covering car seats, your bed, and any other furniture that you might rest on with a waterproof
- pad or cover.
- Wear old, loose, dark colored clothes to the office on the day of surgery. Sweats and warm-ups
- suits tend to work best. Women are usually most comfortable in a cotton sports-type bra. Be
- aware that anything you wear to surgery may end up ruined by tumescent anesthesia drainage.
- Men should bring an extra pair of boxers or briefs
PROCEDURE OF LIPOSUCTION
Depending on the type of liposuction you are undergoing, the procedure may be performed as an outpatient procedure at the doctor’s office or surgery center, or if large amounts of fat are being removed, the procedure will be done in a hospital and may require an overnight stay.
Before the procedure begins, you will be given anesthesia. Again, depending on the degree of fat being removed and the type of liposuction being performed, anesthesia varies and may only be locally applied or it may require a general application in which case the surgery will be done while you are sleeping.
Once the anesthesia has taken effect, the liposuction procedure is performed using a suction device attached to a small, stainless steel instrument called a cannula. Through small incisions, the cannula is inserted into fatty areas between skin and muscle where it removes excess fat either using a suction pump or a large syringe. This results in a smoother, improved body contour. The length of the procedure will vary with the amount of fat needing removed.
POSTOPERATIVE PROCEDURE OF LIPOSUCTION
- Immediately following surgery,, absorbent dressings will be placed on incision wounds to collect
- drainage and you will be fitted with a tight compression garment which will facilitate retraction
- of the skin over suctioned areas. Please wear the garment overnight. If the absorbent pads
- become saturated with drainage, they may be replaced with dry absorbent pads if this can be
- done without removing the garment.
- Sitting in an upright position will facilitate drainage. If you lay flat on your back at home
- immediately after liposuction, you will start draining profusely as soon as you next stand up.
- After 6-8 hours postoperatively you may lie flat, and sleep in any comfortable position.
- The morning after the surgery, you may remove the garment and absorbent dressings and take
- a shower. Wash and dry your garment. It is perfectly acceptable for incision wounds to get
- wet after this point. Wash incision sites with soap and water, apply a small amount of Vaseline
- ointment and cover incision with Band-Aids. Repeat wound care once daily until your post-op
- Put your compression garment back on.
- Garments should be worn from 18-24 hours per day during the first two (2) post-operative
- weeks, then may be replaced with a body slimmer or body shaper 12-18 hours per day for
- the following four (4) weeks. These may be found in the lingerie section of most department
- stores, or at www.lipoinabox.com.
- We recommended avoiding strenuous activity for the first two to three days following surgery.
- Be sure to get out of bed for meals, bathroom, etc. to keep the circulation in your legs flowing.
- Most patients are usually able to return to normal activity and work within 2-3 days following
COMPLICATIONS OF LIPOSUCTION
Common side effects of liposuction include:
- Temporary swelling, bruising, soreness, and numbness in and around the treated areas.
- Irritation and minor scarring around the incision sites where the cannulas were inserted.
- Baggy or rippling skin. The skin will usually tighten and retract after a few months. But in some people the skin may remain somewhat loose.
Less common side effects include:
- Permanent color changes in the skin.
- Uneven skin surface over the treated area.
- Damage to the nerves and skin. The heat generated during ultrasound-assisted liposuction may burn the skin or damage the tissue under the skin.
- Excessive blood and fluid loss, leading to shock. But this is extremely unlikely.
- Fat clots or blood clots, which may travel to the lungs (pulmonary embolism) and become life-threatening.
- Buildup of fluid in the lungs (pulmonary edema). This is most likely to occur when a large volume of fluid is injected into the body.
- In some cases, antibiotics may be given before or after liposuction to help prevent infection.
- Toxic reaction to the injected solution (lidocaine toxicity), especially if large areas or many areas are treated at one time.
- A puncture into the cavity containing the abdominal organs or damage to an organ such as the spleen.