What is Liposuction?
Liposuction or Lipoplasty is one of the most popular
procedures today. This surgical procedure removes unwanted,
localized, disproportioned excess fat from different areas
of the body. It is also used to slim the hips and thighs,
flatten the abdomen, shape the calves and ankles or even get
rid of a double chin. It has been adopted by many medical
practitioners especially those without formal training in
plastic surgery because of the simplicity of the concept,
vacuuming of unwanted fat from areas of the body. It is
important to note, however, that liposuction is not a
substitute for weight loss. You should discuss with your
surgeon the proper indications for the procedure,
alternatives to the procedure and how to manage potential
risks.
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Effects of Liposuction
Getting a Liposuction will give your body a more slender,
sculpted and well-proportioned look, in addition to boosting
your self-confidence.
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Candidates for Liposuction
Liposuction can easily improve body contours caused by
excess fat. Most of the time, some areas are not responsive
to diet and exercise even though you are at your ideal
weight. Younger patients, whose skin is more elastic, are
more likely to get the best results because the skin will
smoothly re-contour after the procedure. For older patients
however, whose skin may not be as elastic, a skin-tightening
procedure (Abdominoplasty or Body Contouring) may be
required. Contrary to belief, Liposuction cannot correct
contours that are irregular for other reasons, such
as muscle weakness or hernia, and it is not applicable in
cases where there is excessive skin laxity (for example, the
abdomen after multiple pregnancies) or “cellulite”.
Although together with additional procedures, Liposuction
can correct these deformities with good results. Localized
accumulation of excess fatty and breast tissue in teens or
adult males, also called
Gynecomastia, or Male Breast
Enlargement
can also be treated by Liposuction.
The
areas that respond well to Liposuction include:
• Cheeks, jowls, and neck
• Upper arms
• Breast or chest areas
• Back
• Abdomen and waistline
• Hips and buttocks
• Inner and outer thighs
• Knees, calves and ankles
It is
important to remember that Liposuction is a Body Contouring
technique, not a method of surgical weight reduction.
Although in large-volume Liposuction there is usually a
noticeable and often dramatic improvement of the body
contours, there may be relatively little change in the
patient’s weight after surgery, since fat is less dense
(lighter in weight) than a comparable volume of water.
Liposuction is not effective on diffuse, generalized excess
fatty deposits. BHMG advises patients that a
medically-supervised weight reduction program is most
beneficial in such cases, in order to arrive at or near
their ideal goal weight before Liposuction is done.
Liposuction works hand-in-hand with a healthy, low-fat diet
and a program of regular exercise, to restore your shape, or
to create the shape you have always dreamed of, minus the
unwanted bulges that never seem to go away, even with your
best efforts at diet and exercise.
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Your
Consultation
You
will be asked by your surgeon to point out areas that
concern you and would like to see improved. Realistic
expectations about what can and cannot achieve by the
procedure will also be mentioned by your surgeon.
Liposuction is most successful in people with normal body
weight, with good skin tone and those who have isolated
unwanted fatty deposits. It is important to note that
Liposuction is not a treatment for obesity and usually your
weight will not change abruptly after the procedure. Rather,
it helps improve a patient’s body contour. If weight gain
occurs after Liposuction, the fat may be deposited in areas
that have not been treated. But not to worry, the procedure
can be repeated if necessary.
Factors like a patient’s physical condition, genetic make
up, diet, exercise, smoking alcohol and skin elasticity can
affect the results of the procedure. In addition to the
usual consultation, BHMG’s Certified Surgeon will also
carefully evaluate your general state of health, any
underlying conditions which may compromise your result and
any medications you maybe taking should be discussed in
detail. Your surgeon will estimate the amount of fat that
should be removed from each area of concern, in order to
achieve the best results.
BHMG’s surgeons will select the proper technique and
instrumentation necessary in a patient’s case, plus the
different options and relative risks and benefits for each
procedure and tailor fit it to receive maximum results.
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The Liposuction
Procedure
Liposuction is done on an outpatient basis and under light
general anesthesia. Discreet incisions, either hidden in
the patient’s natural skin fold or in a very inconspicuous
place, are positioned adjacent to the areas to be treated.
A small (2.5 to 5 millimeter) metal suction tube called a
cannula is attached to a surgical vacuum machine or
syringe, then inserted through miniscule incisions and
directed below the skin into the fatty deposits requiring
treatment. Liposuction usually takes over an hour,
depending on the number of areas to be treated.
Options and Alternatives
“Tumescent” Technique
In
this technique, local anesthesia, wherein a dilute solution
of local anesthetic is infiltrated under pressure into the
fatty areas to be liposuctioned, is used in certain
circumstances, either with or without a sedative. Small,
localized areas can be treated with tumescent local
anesthesia alone, but the injection of the local anesthetic
solution itself may be uncomfortable or painful.
“Wet” and/or “Super-wet” Technique
Local
anesthesia is used in most cases and involves the use of
lesser quantities of similar dilute solutions of local
anesthetic, usually in conjunction with light general
anesthesia or intravenous sedation. This will diminish the
blood loss associated with Liposuction and provide
long-lasting pain relief both during and after the
procedure. Because the local anesthetic solution is
infiltrated after the sedation or general anesthetic, the
injections themselves are painless. This is the usual
technique used in cases where Liposuction of multiple areas
is planned.
In addition to traditional vacuum Liposuction, there are
other types of instrumentation which can be useful in
certain situations.
Power-Assisted Liposuction (PAL)
This
involves the use of a special mechanical hand piece that
produces a rapid reciprocating movement of a standard-type
cannula tip (similar to a sewing machine). used in areas of
dense or fibrous fat, or in secondary Liposuction cases,
passage of the cannula is easier, and the fat is
simultaneously vacuumed away, as in traditional Liposuction.
Ultrasound-Assisted Liposuction (UAL)
This
method involves the use of a specialized hand piece and
cannula tip connected to an ultra-high-frequency sound wave
generator. Vibrations above the range of human hearing
(ultrasound) are transmitted to the cannula tip, and fat in
the areas of treatment is liquefied and emulsified by
bursting of the cell membranes. A separate cannula and
low-pressure vacuum are then used to remove the liquefied
fat emulsion. This technique is also applied in difficult
or secondary cases, but has somewhat greater associated
risks.
Autologous Fat Grafting
In
this procedure, the excess fat is transferred to an area
where you desire increased fullness, such as the lips, other
lines in the face, or areas of cellulite dimpling. Many
patients ask if this fat can be transferred to the breast;
however, fat transfer to the breast is not advisable,
because it occasionally can produce small areas of
calcification that resemble early signs of breast cancer on
mammograms.
Liposuction is not the answer to the laxity of the skin in
the treated areas, and in some cases may worsen the
appearance of the skin. There are instances where an
alternative body contouring surgical procedure may be
required, most commonly in combination with liposuction of
the involved areas. Abdominoplasty or Lower Body Lift may be
required for areas like the abdomen and hip. While the loose
skin of the upper arms may require Brachioplasty (Arm Lift)
and the sagging skin of the inner thigh may require Thigh
Lift. A Face or Neck Lift maybe required for a double chin
in order to achieve ultimate results.
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Recovery
Recovery from Liposuction is relatively easy. After the
operation, a patient may feel somewhat stiff and sore but
the day after surgery, the patient should be up and walking
around to promote normal circulation. Swelling, possibly to
the point where the treated areas appear unchanged or
heavier before the surgery, may be expected. There will
most likely be bruising about 2 weeks after the procedure,
which maybe extensive and may involve untreated areas. The
patient is advised to wear a special elastic compression
garment to provide pressure on the area and minimize
swelling and provide support while healing. These garments,
although hot and comfortable, will also help in the
retraction of the skin. Depending on a patient’s healing
time, stitches will be removed within a week.
Patients can go back to work after 3 to 5 days. While more
strenuous activities, like going to the gym should be done
after 10 to 14 days. Patients are advised to avoid the sun
and use generous amounts of sunscreen until all bruising has
subsided.
The
results will be recognizable immediately after Liposuction
and will continue to improve once swelling subsides. The
unwanted bulges will be gone, giving you a slimmer contour.
Results of Liposuction are permanent if combined with a
healthy diet, moderate exercise and weight management
program. In the event of weight gain following your
surgery, you might note a more generalized, more even
distribution of excess fat, rather than re-accumulation in
the previous problem areas where treatment was performed.
BHMG
surgeons will recommend another procedure if necessary, to
further improve the areas of Liposuction.
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Risks
There are very rare complications after Liposuction but
occasional complications may occur. Although permanent
problems are quite rare, potential short term complications
include bleeding, infection and reactions to the
anesthesia. While depressions or wrinkling of the skin,
discoloration of the skin, asymmetry when comparing one side
to the other, scar tissue, tape burns, and collections of
blood (hematoma) or fluid (seroma) under the skin are some
of the cosmetic complications that may need additional
surgical procedures.
Uncommon complications include loss of sensation or movement
in a body area, skin breakdown or loss requiring skin graft
or reconstruction, and fat embolism or blood clots in the
lower leg veins which may travel to the lungs (pulmonary
embolism). Serious infection, or shock requiring
hospitalization and blood transfusion, are very rare. Some
bleeding and fluid shift is expected during Liposuction.
This is the reason why there is a limit to the amount of fat
removed. If BHMG’s surgeons anticipate a large volume of fat
to be removed (beyond the safe limit of a single operation),
they will recommend that the overall operation be divided
into multiple stages separated by several weeks or months of
recuperation, in order to safely accomplish the desired goal
without the need for blood transfusion.
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Frequently Asked
Questions
Q: How
much weight will I lose after Liposuction?
A:
In the case of younger patients, their skin has sufficient
elasticity and resilience so it can shrink and contract
nicely over the areas of fat that have been removed. If the
skin has been stretched beyond recovery by years of
localized fatty excess, Liposuction may need to be combined
with another Body Contouring procedure to remove the excess
Q:
What is the maximum volume of fat that can be removed in one
operation?
A:
Five liters is the maximum safe volume of fat that can be
removed during Liposuction. The actual safe volume may be
greater or less than that amount, depending upon the amount
of bleeding observed or other factors such as changes in the
patient’s vital signs during the procedure.
Q: Is a blood transfusion required for patients
undergoing Liposuction?
A:
No. If it is anticipated that there may be a greater risk of
blood loss during the procedure (secondary liposuction,
large volume liposuction in men), BHMG may suggest that you
donate a unit of your own blood (Autologous Blood), which
can be given to you during the procedure. In general, blood
transfusions (even Autologous Blood) should be discouraged,
to avoid the risk of transfusion errors and transmission of
blood-borne illnesses.
skin.
Q: If I gain weight after Liposuction, will the fat be
deposited in other locations?
A:
Since the fat deposits your body previously used to store
excess fat have been reduced, you may find that fat would
accumulate in other areas of the body after Liposuction.
Generally, this tendency of the fat to shift to other areas
is minimal, but you should obviously avoid regaining the
weight.
Q: How
long do I need to wear the elastic compression garment after
Liposuction?
A:
The elastic compression garment is used to diminish the
amount of swelling and bruising in the treated area. It
also prevents accumulation of excess fluid (serum or blood)
under the skin, and helps to maintain the contour of the
treated area. It should be worn continuously, 24 hours a
day, 7 days a week (except while showering) for the first 3
to 4 weeks. After that time, it can generally be used for
support and comfort during the daytime only, for an
additional 3 weeks.
Q:
When can I shower or bathe after Liposuction?
A:
You may shower after the first office visit / dressing
change, generally within 24 to 48 hours after surgery. You
must not bathe or immerse the incision sites under water in
a bathtub, hot tub, swimming pool, etc. until the incisions
are completely healed. The doctor will instruct you when
bathing is permitted.
Q:
When can I resume driving?
A:
Most patients may resume driving after approximately 48 to
72 hours. You should not drive if you are taking narcotic
pain medication, sedatives or muscle relaxants.
Q: When can I resume exercise?
A:
Patients are encouraged to begin walking immediately after
surgery. You may resume more strenuous walking on a
treadmill, or mild upper extremity weight training after 7
to 10 days. Most patients resume full, unrestricted
exercise after approximately 4 weeks.
Q:
When can I return to work or normal social activities?
A:
Most patients are able to return to work or resume normal
social activities after 3 to 4 days. If your work involves
sitting for extended periods, you are encouraged to take
frequent breaks to stand and walk, in order to promote
circulation and deep breathing. You will need to wear
loose-fitting clothing which will hide the presence of your
compression garments, as long as necessary.
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