Liposuction

It is designed for the permanent removal of fatty tissue, commonly referred to as “cellulite.” It is an elective procedure that allows the plastic surgeon to remove undesirable, subcutaneous fat in isolated areas that do not respond to diet and exercise. These areas include the hips, thighs, abdomen, knees, ankles, face and neck.

Liposuction is most successful in people with good skin tone who have fatty deposits. It is not a treatment for obesity. If weight gain occurs following liposuction, the fat will be deposited in areas that have not been treated. The procedure can be repeated, if necessary. To maintain the safety of the procedure, there is a limit on how much can be done at one time.

A variety of factors can affect the results: Physical condition, genetic makeup, diet, exercise, smoking, alcohol intake, and skin elasticity.

Body contours made irregular by fat can be improved by this procedure; it cannot correct contours that are irregular for other reasons, such as muscle weakness or hernia. However, combined with other procedures, liposuction can correct these other deformities with good results.

To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. 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. Before you decide to have surgery, think carefully about your expectations and discuss them with the surgeon.

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 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.

In women we commonly treat hips, thighs, love handles, tummy, buttocks and knees. Liposuction is also used to treat the neck, breasts and other areas. In men the common areas treated are the chest, tummy and neck.

The tumescent technique is a relatively new liposuction method that can reduce post-operative bruising, swelling and pain. Because blood loss is minimized during tumescent liposuction, use of the technique reduces the chance that a blood transfusion will be needed.

In the tumescent technique, areas of excess fat are injected with a large amount of anesthetic liquid before liposuction is performed. The liquid causes the compartments of fat to become swollen and firm or “tumesced.” The expanded fat compartments allow the liposuction cannula to travel smoothly beneath the skin as the fat is removed.

Any person who is a candidate for traditional liposuction is also a good candidate for the tumescent technique. Although the technique can be used on any area of the body, it is commonly used on areas that require precise enhancement, such as the face, neck, arms, calves and ankles. Individuals who have large areas of excess fat may also be good candidates for tumescent liposuction.

  • Blood tests are sometimes performed and photographs are taken to assess post-operative effectiveness.
  • No aspirin, ibuprofen, or similar drugs should be taken within two weeks of surgery. These medications can cause serious excess bleeding during, and after, the operation. If you have any questions about drugs you are taking, including over the counter preparations and natural herbs, please call the office.
  • Do not eat or drink anything after midnight of the night before your surgery. This prohibition includes coffee and juice in the morning. Oral medications can be taken with a sip of water.

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 pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon’s preference. If many sites are being treated, the surgeon will then move on to the next area, 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. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery.

Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, 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.

Large volumes of fluid — sometimes as much as three times the amount of fat to be removed — are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as 4 to 5 hours). However, because the injected fluid contains an adequate amount of anesthetic, additional anesthesia may not be necessary. The name of this technique refers to the swollen and firm or “tumesced” state of the fatty tissues when they are filled with solution.

The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are 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.

Information
AnesthesiaGeneral.
Surgery Length1 to 2 hours or more.
Side EffectsTemporary bruising, swelling, numbness, soreness, burning sensation. Tumescent: Temporary fluid drainage from incision sites.
Recovery PeriodBack to work: 1 to 2 weeks. More strenuous activity: 2 to 4 weeks. Full recovery From swelling and bruising: 1 to 6 months or more. Use of tumescent technique may decrease post-operative bruising and swelling.
Stay in Hospital1 day
Stay in Thailand7 days
  • It is completely normal and expected to have a significant leakage of tumescent fluid for the first 24 hours after the procedure. This fluid is often tinted with some blood and may appear to represent a significant blood loss. It is important to realize that this leakage is normal and harmless. Should significant dark red blood or clots appear after surgery, call the office immediately.
  • Nearly all patients will be placed into a compressive garment at the conclusion of the procedure and should wear this garment for at least 2-4 weeks after the operation. Most patients will go home several hours after the surgery.

Recovery

Recovery from liposuction is relatively easy. Expect a fair amount of swelling and bruising in the following two weeks. You will wear special garments provided to apply pressure, minimize swelling and provide support while healing. These garments also assist in retraction of the skin. Stitches will be removed in a week to 10 days.

Results are recognizable almost immediately and will continue to improve as swelling subsides. The day after surgery you should be up and walking around. Increase your activity daily until full activity is resumed at 2-4 weeks. You will be ready to return to office work in 3-5 days and more active employment at 10-14 days. Avoid the sun until all bruising has subsided. A sunscreen should be used routinely; it is easy to get sunburned during recovery because of decreased sensation.

Don’t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, 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.