THE BEST CANDIDATES FOR LIPOSUCTION
The best candidates for liposuction are normal weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration, however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin. Liposuction is not a weight reduction procedure.
Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.
PLANNING YOUR SURGERY
In your initial consultation, we will determine where your fat deposits are, assess the condition of your skin, and explain the body contouring methods that may be most appropriate for you. For example, if you believe you want liposuction in the abdominal area after pregnancy, you may learn that an abdominoplasty or “tummy tuck” may be more appropriate to effectively meet your goals. Be frank in discussing your expectations.
GETTING THE ANSWERS YOU NEED
Individuals considering liposuction often feel a bit overwhelmed by the number of options and techniques being promoted today. In deciding which is the right treatment approach for you, your doctor will consider effectiveness, safety, cost and appropriateness for your needs.
Your surgeon’s education and training have helped to form his surgical judgment, so take the time to do some background checking. Patients are encouraged to consider a doctor certified by the American Board of Plastic Surgery (ABPS). By choosing a plastic surgeon who is certified by the ABPS, a patient can be assured that the doctor has graduated from an accredited medical school and completed at least five years of additional residency – usually three years of general surgery and two years of plastic surgery. To be certified by the ABPS, a doctor must also practice surgery for at least two years and pass comprehensive written and oral exams.
(Refer to the section entitled The Educated Patient on this site.)
While you are making preparations, be sure to arrange for someone to drive you home after the procedure and, if needed, to help you at home for a day or two.
WHERE YOUR SURGERY WILL BE PERFORMED
Liposuction is usually performed in an outpatient surgery center. Smaller volume liposuction is usually done on an outpatient basis for reasons of cost and convenience. If liposuction is extensive or if the liposuction is being performed in conjunction with other procedures, an overnight stay in the outpatient center may be required.
ANESTHESIA FOR LIPOSUCTION
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. Liposuction is usually performed in an outpatient center under general anesthesia. Small areas, or touch up areas of liposuction can be performed in the office with local anesthesia.
The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, and the technique used.
There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance the outcome:
Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is then pushed through the fat layer, breaking up the fat cells and suctioning them out. The suction is provided by a vacuum pump or a large syringe, depending on the surgeon’s preference. If many sites are being treated, your surgeon will then move on to the next area, working to keep the incisions as inconspicuous as possible.
Tumescent liposuction is a technique in which a medicated solution is injected into a fatty area before the fat is removed and is commonly used by plastic surgeons today. The fluid, a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels), helps the fat be removed more easily, reduces blood loss, and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery. The amount of fluid that is injected varies depending on the preference of the surgeon. Fluid is lost along with fat, and it’s crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery.
Laser-Assisted Liposuction requires the use of a special cannula which uses laser energy. As it passes through the areas of fat, the laser energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique. Laser liposuction 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, laser liposuction takes longer to perform than traditional liposuction and is more expensive.
Liposuction is normally safe: as long as patients are carefully selected; the operating facility is properly equipped; and the physician is adequately trained.
At a minimum, your surgeon should have basic (core) accredited surgical training with special training in body contouring. Also, even though many body contouring procedures are performed outside the hospital setting, be certain that your surgeon has been granted privileges to perform liposuction at an accredited hospital, in case hospitalization is necessary.
There are also points to consider with the newer techniques. For example, with a laser, the heat from the device used to liquefy the fat cells may cause injury to the skin or deeper tissues. Also, you should be aware that even though laser has been performed successfully for some time, the long term effects on the body are not yet known.
The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even “baggy,” especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.
AFTER YOUR SURGERY
After surgery, you will likely experience some fluid drainage from the incisions. To control swelling and to help your skin better fit its new contours, you will be fitted with a snug elastic garment to wear over the treated areas. You will need to wear this garment for at least 2-3 months to get the best results.
Don’t expect to look or feel great after surgery. Even though the newer techniques are believed to reduce some post-operative discomfort, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days.
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
Healing is a gradual process. Your surgeon will probably tell you to start walking around as soon as possible to reduce swelling and to help prevent blood clots from forming in your legs. You will begin to feel better after about a week or two and you should be back at work after that period. The stitches dissolve on their own within the first week to 10 days.
Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more. Deep tissue massage and exercise are recommended after about a week.
YOUR NEW LOOK
You will see a noticeable difference in the shape of your body quite soon after surgery. Improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.
If your expectations are realistic, you will probably 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.