Liposuction

The Best Candidates for Liposuction

The best candidates for liposuction are normal-weight people with firm, elastic skin, pockets of excess fat in certain areas, who have realistic expectations about what the procedure can and can’t do for them. They are physically healthy and psychologically stable. Age is not a major consideration, though the diminished skin elasticity of older patients means that their results may not match those of younger patients. People with poor circulation, lung disease, have recently had surgery near the area to be contoured, or who have other medical problems face higher risk than patients without such problems.

It’s important to understand that liposuction can enhance your appearance and self confidence, but it won’t necessarily change your looks to match your ideal or cause other people to treat you differently. Think carefully about your expectations before you decide to have surgery, and discuss them with your surgeon.

Getting the Answers You Need

It’s easy to feel a bit overwhelmed by the number of liposuction options and techniques available today, but your plastic surgeon can help. In considering which treatment is the right approach for you, your doctor will consider the effectiveness, safety, and cost of each, and how appropriate each is for your needs. This surgical judgment is a skill that is developed through training and surgical experience. Your doctor uses this same judgment to prevent complications, handle unexpected occurrences during surgery, and to treat complications when they occur.

Since your surgeon’s education and training have helped to form his or her surgical judgment, take the time to do some background checking. An important consideration is choosing a doctor certified by the American Board of Plastic Surgery (ABPS). To be certified by the ABPS, a doctor must practice surgery for two years and pass comprehensive written and oral exams, graduate from an accredited medical school and complete at least five years of additional residency – usually three years of general surgery (or its equivalent) and two years of plastic surgery. By choosing an ABPS certified plastic surgeon, a patient can be assured that the doctor has ample preparation.

Preparing For Your Surgery

In your initial consultation, your surgeon will evaluate your health, where your fat deposits lie, and the condition of your skin. Your surgeon will explain the body-contouring methods that he believes will be most appropriate for you. You may believe you want abdominal liposuction, then learn from your doctor that an abdominoplasty (tummy tuck) or that a combination of traditional liposuction and UAL may more effectively meet your goals.

Be frank in discussing your expectations with your surgeon, and expect him or her to be equally candid with you, describing the procedure in detail and explaining its risks and limitations.

It is important to follow the pre-surgery guidelines provided by your surgeon, including recommendations regarding intake of food or drink as well as vitamins, smoking, supplements, medications, and so forth. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed. Some procedures even necessitate having blood drawn ahead of time, to be used during the surgery if needed.

Procedures can be performed in an out-patient facility or a hospital with either general or local anesthesia (depending on factors such as how extensive the surgery is to be), and knowing the details beforehand and planning ahead for a ride home, an overnight stay, or a few days’ assistance at home goes a long way towards peace of mind. Smaller-volume liposuction is usually done on an outpatient basis for reasons of cost and convenience. However, if a large volume of fat will be removed, or if the liposuction is being performed in conjunction with other procedures, a stay in a hospital or overnight nursing facility may be required.

The Surgery

Various types of anesthesia can be used for liposuction procedures. Together, you and your surgeon will select the type of anesthesia that provides the most safe and effective level of comfort for your surgery.

In cases where only a small amount of fat involved and the number of body sites are limited, local anesthesia, which numbs only the affected areas, can be used. The local anesthetic can be used along with intravenous sedation to keep you more relaxed during the procedure, if you prefer. Regional anesthesia, such as an epidural block like those commonly used in childbirth, can be a good choice for more extensive procedures. Some patients prefer general anesthesia, particularly if a large volume of fat is being removed. In such cases, a nurse anesthetist or anesthesiologist will be called in to make sure you are completely asleep during the procedure.

The time required to perform liposuction varies considerably, and depends on:

  • The size of the area being targeted
  • The amount of fat being removed
  • The type of anesthesia used
  • Which of the several possible techniques is chosen

The goal of liposuction is to re-contour one or more areas of the body by removing localized deposits of fat. A narrow tube, or cannula, is inserted through a tiny incision and pushed and pulled through the fat layer, breaking up the fat cells, then suctioning them out. The suction is provided by a vacuum pump or a large syringe, depending on the surgeon’s preference. If multiple sites are being treated, your surgeon will then move on to the next area, always working to keep the incisions as inconspicuous as possible.

Fluid is lost along with the fat, and it’s crucial that this fluid be replaced during the procedure to prevent shock. Patients are, therefore, carefully monitored and given intravenous fluids during and immediately after surgery.

Technique Variations

The basic process of liposuction described above is used in all patients undergoing this procedure. As the procedure has been developed and refined, however, some variations have been introduced.

  • In the Fluid Injection technique, a medicated solution is injected into fatty areas before the fat is removed. This is a commonly used technique today. The fluid is a mixture of saline solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) that, reduces blood loss, provides anesthesia during and after surgery, reduces the amount of bruising after surgery, and simply helps remove the fat more easily. How much fluid is injected depends on the preference of the surgeon. For example;
  • In the Tumescent technique, as much as three times the amount of fat to be removed is injected into the targeted areas. Tumescent liposuction is typically performed on patients who need only a local anesthetic and can take significantly longer than traditional liposuction (up to 5 hours). Because the injected fluid contains sufficient anesthetic, however, additional anesthesia may not be necessary. The name of this technique refers to the swollen, firm state of the fatty tissues when filled with solution.
  • The Super-Wet technique is similar to the tumescent technique, except that less fluid is used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.
  • Ultrasound-Assisted Lipoplasty (UAL) requires the use of a special, ultrasonic energy producing cannula. This energy explodes the walls of the fat cells. This liquefies the fat, which is then removed with traditional methods.UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.

All Surgery Carries Some Uncertainty and Risk

Even though lipoplasty is among the safest of cosmetic surgeries, it nevertheless presents a measure of risk.

The ultrasound energy used to liquefy fat cells and ease the process of removal in the UAL technique can also cause burns to the skin and even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known. The high doses of anesthetic injected into the area being treated in the tumescent and super-wet techniques can cause toxicity if levels and absorption are not managed properly. And even though a well-trained surgeon and a state-of-the art facility can improve your chance of having a good result, there are no guarantees. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size, since removing more tissue means a longer procedure with more opportunity for complications to arise.

Though liposuction scars are small and strategically placed to be hidden from view, imperfections in the final appearance such as irregularity, lack of symmetry, and even baggy skin are not uncommon, especially in older patients. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.

At minimum, your surgeon should have core accredited surgical training with special training in body contouring. Dr. Hallak reminds his clients to be sure that their doctor has been granted privileges at an accredited hospital whether the procedure will be performed there or not. Ask your doctor about his or her other patients who have had similar procedures and what their results were. More extensive liposuction procedures require attentive after-care, so find out how your surgeon plans to monitor your condition closely after the procedure.

After Your Surgery

Do not to expect to either look or feel “great” right after surgery. Post-operative discomforts such as swelling, temporary numbness, burning, and bleeding are normal, and generally controlled with medicines prescribed by your surgeon. A small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. To control swelling and help your skin better fit its new contours, you may be fitted with a snug elastic garment to wear over the treated area for a few weeks. Your doctor may also prescribe antibiotics to prevent infection.

It is normal to feel a bit anxious or depressed in the days or weeks following surgery. However, this feeling will subside as you begin to look and feel better.

Getting Back to Normal

Since healing is a gradual process, your surgeon will probably tell you to start walking around as soon as possible, as this helps to reduce swelling and prevent blood clots from forming in your legs. You should begin to feel better after about a week or two and you should be back at work within a few days following your surgery. The stitches are either removed or will dissolve on their own within the first week to 10 days. Strenuous activity should be avoided for about a month as your body continues to heal. Most of the bruising and swelling disappears within three weeks, but some swelling may remain for six months or more.

Your surgeon will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed. If you have any unusual symptoms between visits, such as heavy bleeding or a sudden increase in pain, or any questions about what you can and can’t do, call your doctor.

Your New Look

Though you will see a noticeable difference in your body’s shape soon after surgery, improvement will become even more apparent after about four to six weeks. By then most of the swelling will have subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.

If your expectations are realistic, you can expect to be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.

If you are considering having liposuction in San Diego contact us today.

 

 

Women may have liposuction performed under the chin, on their hips, thighs, and stomach, and in the under arm and breast area.

 

For men, common sites include under the chin and around the waist. Liposuction may also be used in the reduction of enlarged male breasts, a condition known as gynecomastia.

 

Healthy, normal-weight people with elastic skin and pockets of excess fat are good candidates felp, how it is performed and how you might look and feel after surgery. It won’t answer all of your questions because a lot depends on your individual circumstances. Please ask your doctor if there is anything about the procedure you don’t understand.