Liposuction (Lipoplasty)

Liposuction (lipoplasty) is particularly well suited for women and men who are of relatively normal weight but have isolated pockets of fat that cause certain areas of their body to appear disproportionate. These localized fat deposits may sometimes be an inherited trait and typically do not respond to dieting or exercise. Liposuction is often the only way to eliminate them.

While it is possible to undergo liposuction at almost any age, you will obtain the best results if your skin still has enough elasticity to achieve a smooth contour following fat removal. When skin is inelastic, as in some older patient, it may not redrape well and a skin tightening procedure may be necessary.

Liposuction may sometimes be used to treat a condition called gynecomastia, or male breast enlargement, which frequently occurs among both teenage and adult males.

Liposuction should not be considered a substitute for overall weight loss, nor is it an effective treatment for cellulite, a condition that gives the skin an uneven, dimpled appearance. Alternatively, treatments may be considered, in some instances, to improve this problem.

Liposuction can be performed on several areas of the body at the same time, and it can also be done in conjunction with other aesthetic plastic surgery.

EVALUATION

You may be a good candidate for liposuction if you have localized excess fat or if you desire contouring in any of the following areas:

-Cheeks, jowls, and neck

-upper arms

-breast or chest areas

-back

-abdomen and waist

-hips and buttocks

-inner and outer thighs

-inner knees

-calves and ankles

Because of individual physical factors, not everyone will achieve the same results from liposuction. Your plastic surgeon will take into consideration your unique characteristics in determining the most effective treatment. During the consultation, you will be asked to point out the exact areas which you would like to see improved. This will help your surgeon to understand your expectations and determine whether they can realistically be achieved.

Your plastic surgeon will examine you while you are standing. Your skin tone and the amount of excess fat, and the location of the fat will be assessed.

You should come prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries, and medications that you currently take. It is important for you to provide complete information.

How much you currently weigh and whether you plan to lose or gain weight in the future will be factors in evaluating you for liposuction. Your plastic surgeon may ask you about the effects of prior weight loss on the appearance of those areas which you have indicated for contouring. He or she will assess the elasticity of your skin and estimate the amount of fat to be removed for optimal results.

SURGICAL TECHNIQUE

Fat is removed by first inserting a small, hollow tube, called a cannula, through one or more tiny incisions near the area to be suctioned. Incisions are usually less than one-quarter inch in length and are placed as inconspicuously as possible, often within skin folds or contour lines. The cannula is connected by tubing to a vacuum pressure unit. Guided by the surgeon, the suction device literally vacuums away the unwanted fat.

Prior to performing liposuction, fluid is instilled into the areas to be suctioned. Plastic surgeons may use a ‘dry’ technique, a ‘tumescent’ technique that introduces large amounts of fluid, or other variations, most of which introduce smaller amounts of fluid than the ‘tumescent’ technique. Your surgeon will discuss with you the particular method that he or she recommends for treating specific areas of your body.

Other options may involve the type of instrumentation used or whether suctioning is performed on the deep or more superficial layers of fat. Ultrasonic and Vaser technology involves high frequency sound waves to deliver energy to emulsify fat prior to suctioning. Power assisted liposuction utilizes mechanical vibration to allow the cannula to travel more easily through the fatty tissue. Currently, there has been development and media coverage of the use of a laser device inserted through a small skin incision; but unlike the other variations, there is no actual suction involved. This technology has not been able to demonstrate any significant effects at this time.

RISKS AND COMPLICATIONS

Fortunately, significant complications from liposuction surgery are infrequent. Every year, many thousands of women undergo successful liposuction surgery, experience no major problems and are pleased with the results.

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Blood accumulations under the skin are possible, but these normally resolve themselves and rarely require removal. While numbness of the skin following liposuction is almost always temporary, it is possible for some lack of sensation to persist or for skin discoloration to appear in treated areas. Contour irregularities including depressions or wrinkling of the skin can result in some patients, but treatments are usually available to help minimize these problems if they occur.

PREPARATION FOR SURGERY

If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions.

Liposuction surgery will be performed on an outpatient basis. You will need someone to drive you home and stay with you overnight and the next day to drive you to your surgeon’s office. Alternatively, there are aftercare facilities available that specialize in the care of plastic surgery patients for one or more days after their surgery. These facilities are operated inside hotels located nearby the surgery center, and staffed by registered nurses.

SURGERY

The goal of your plastic surgeon and the entire staff is to make your surgical experience as easy and comfortable for you as possible.

Your surgery will be performed in a fully accredited outpatient surgery center in the same building as your surgeon’s office. A general anesthetic is administered, so that you will be asleep throughout the procedure. Afterward, you will be taken into a recovery area where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication which you may continue taking at home. Compressive dressings such as an elastic garment or abdominal binder have been placed over the areas that were suctioned. Your surgeon will tell you how long you should wear the garment and will instruct you on how to remove it so that you may shower or bathe.

You probably will be permitted to go home after a few hours, although some patients may stay overnight in a surgical aftercare facility.

RECOVERY

The day after surgery, you will need to move around occasionally to promote blood circulation. Your plastic surgeon will advise you to limit yourself to these brief periods of gentle activities for the first few days. Remember, you must not take aspirin or certain anti-inflammatory medications, and you should not smoke for two weeks following surgery.

Your dressings will be temporarily removed within several days so that your plastic surgeon can examine the treated areas. You will notice swelling and bruising, which is to be expected. Swelling usually begins to subside a week or so following surgery, while bruising can last three weeks or longer. There may also be numbness in some areas, and it may take several weeks before feeling returns. There are usually no stitches to be removed from the incisions because they are buried beneath the skin.

You may be able to return to work in a few days. In many instances, you can resume most of your normal activities within one or two weeks and begin some form of exercise soon after. The timing of your recovery depends largely on the extent of your surgery.

RESULTS

Liposuction surgery will reduce those areas of fatty deposits that previously created unflattering bulges and perhaps made it difficult to feel comfortable in you clothing or caused self-consciousness. Factors such as fluid retention following surgery and prolonged swelling may delay the appearance of your new, slimmer contour. The healing process is gradual, so you should expect to wait a while before fully enjoying the results of your liposuction.

The results of liposuction will be permanent, as long as you maintain your postoperative weight. Even if you gain a few extra pounds, you may find that the weight is distributed more evenly instead of accumulating in the areas that were problematic for you in the past.

Occasionally, a touchup may be desired to further improve an area that has been suctioned. The additional treatment can sometimes be performed under local anesthesia in your plastic surgeon’s office. More extensive revisions may require a return to the operating room.

You will return to your plastic surgeon’s office for follow-up care at prescribed intervals, at which time your progress will be evaluated.