LIPOSUCTION

Despite good health and a reasonable level of fitness, some people may still have a body with disproportionate contours due to localized fat deposits. These areas may be due to family traits rather than a lack of weight control or fitness.

LIPOSUCTION - IMPORTANT TO KNOW

• Liposuction surgery is not a treatment for obesity and is not a replacement for regular exercise and good eating habits.
• Liposuction does not remove cellulite, only fat.
• People with stubborn areas of fat and who exercise regularly could be best candidates for liposuction.

LIPOSACTION candidates

In general liposuction can be performed on any area of the body. At the same time fat removal surgery is not designed to be a quick-fix for obesity, but is instead intended for use in sculpting and reshaping specific areas. In most cases women find it difficult to lose weight from arms, inner and outer thighs, stomach (or abdomen), hips, buttocks, knees and chin.

But not all women with these problems are good candidates for liposuction. Minimum requirements for liposuction include:

• Good overall health;
• Firm and/or elastic skin;
• Average or only slightly above-average weight;
• Concentrated pockets of fat that do not respond well to diet and exercise.

Patients with poor skin quality (cellulite) are not good candidates for liposuction because they may develop skin irregularities due to under- or over-correction of localized fat deposits. Age is generally not a major consideration when discussing liposuction; however, older patients often have less elasticity in their skin and thus may not achieve the same benefits of liposuction that a younger patient with tighter skin might achieve.

Reasons why liposuction can be performed:

• Cosmetic reasons, including "love handles," fat bulges, or an abnormal chin line;
• To improve sexual function by reducing abnormal fat deposits on the inner thighs, thus allowing easier access to the vagina;
• Body shaping for people who are bothered by fatty bulges or irregularities that cannot be removed by diet and/or exercise.

Liposuction should not be used:

• As a substitute for exercise and diet, or as a cure for general obesity. However, it may be used to remove fat from isolated areas at different points in time.
• As a treatment for cellulite (the uneven, dimpled appearance of skin over hips, thighs, and buttocks).
• In certain areas of the body, such as the fat on the sides of the breasts, because the breast is a common site for cancer.

There are some other alternatives to liposuction including a tummy tuck (abdominoplasty), removal of fatty tumors (lipomas), breast reduction (reduction mammaplasty), or a combination of plastic surgery approaches.

LIPOSACTION preparations before procedure

Before liposuction procedure each client should have a special consultation which will include a history, physical exam and some psychological evaluation. Some pre-operation laboratory tests would be done. All issues about liposuction should be discussed during consultation including possible benefits, side effects and risks.

Before the day of surgery, you may have blood drawn and be asked to provide a urine sample. This allows the health care provider to rule out potential complications. If you are not hospitalized, you will need a ride home after the surgery.

LIPOSACTION types

Different types of liposuction can be discussed with your doctor:

Tumescent liposuction
Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed (sometimes, the solution may be up to three times the volume of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine), and an intravenous (IV) salt solution. The lidocaine in the mixture helps to numb the area during and after surgery, and may be the only anesthesia needed for the procedure. The epinephrine in the solution helps reduce the loss of blood, the amount of bruising, and the amount of swelling from the surgery. The IV solution helps remove the fat more easily and it is suctioned out along with the fat. This type of liposuction generally takes longer than other types.

Liposuction with super-wet technique
The super-wet technique is similar to tumescent liposuction. The difference is that not as much fluid is used during the surgery – in general the amount of fluid injected is equal to the amount of fat to be removed. This technique takes less time; however, it often requires sedation with an IV or general anesthesia.

Ultrasound-assisted liposuction
Ultrasound-assisted liposuction (UAL) is a fairly new technique. During this technique, ultrasonic vibrations are used to liquefy fat cells. After the cells are liquefied, they can be vacuumed out. UAL can be done in two ways, external (above the surface of the skin with a special emitter) or internal (below the surface of the skin with a small, heated cannula). This technique may help remove fat from dense, fiber-filled (fibrous) areas of the body such as the upper back or enlarged male breast tissue. UAL is often used together with the tumescent technique, in follow-up (secondary) procedures, or for greater precision. In general, this procedure takes longer than the super-wet technique.

LIPOSACTION procedure

Sometimes liposuction can be performed in outpatient clinic and sometimes it could be performed in surgery centers or hospitals.

Depending on the degree of fat being removed and the type of liposuction being performed, anesthesia varies. It may only be locally applied or you may require a general application in which case the surgery will be done while you are sleeping.

Once the anesthesia has taken effect, the liposuction procedure is performed using a suction device attached to a small, stainless steel instrument called a cannula. Through small incisions, the cannula is inserted into fatty areas between skin and muscle where it removes excess fat either using a suction pump or a large syringe.

After the procedure, the area of the body that was treated is firmly wrapped to help reduce swelling, bruising, and pain. Elastic bandages and tape, support hose (such as those used to treat varicose veins), a special girdle, or another type of firm-fitting garment may be used, depending on which part of the body was treated. You may have to wear the compression garment or wrap for 3 to 4 weeks. Expect a lot of bruising and swelling for at least the first 7 to 10 days.

Fluid may drain from the incision sites for several days. In some cases, you may be given antibiotics to reduce the risk of infection.

Most people are able to get up and move around as soon as the treatment is finished and after the effects of the anesthesia and any sedation have worn off. You can return to your normal activities as soon as you feel comfortable, although this may take several days to a few weeks. Most people can return to work within a few days. Recovery may take longer if large areas were treated.

Post LIPOSACTION recovery

In most cases the liposuctioned area may appear larger than before surgery because of swelling. After liposuction special bandages are applied to keep pressure on the area and stop any bleeding, as well as to help maintain shape. You must wear a tight stocking, girdle, or snug elastic dressing over the treated area to reduce swelling and bleeding, and to help shrink the skin to fit the new contour. Bandages are usually kept in place for at least 2-3 weeks. Post-operation first visit usually recommended after 5-7 days. Sometimes people gain weight after liposuction. This is due to the increased fluid from surgery.

You may feel sensations such as numbness or tingling, as well as pain, for weeks after the surgery - but it can be managed with medications. Antibiotics may be prescribed to prevent infection. Walk as soon after surgery as possible to help prevent blood clots from forming in your legs. Avoid more strenuous exercise for about a month after the surgery.

You will start to feel better after about 1 or 2 weeks following liposuction surgery.

LIPOSACTION results – temporary or permanent?

During liposuction the fat cells are permanently removed from problematic areas. If you gain weight after liposuction, it usually will not concentrate in the area that was treated. It is important to highlight that liposuction will not prevent you from regaining weight. To keep your new shape and new weight after liposuction, you must follow special low calorie diet and regular exercise plan.

SO, liposuction cannot protect you from future weight gain BUT you can keep post-liposuction weight by keeping diet and exercising regularly – generally speaking by changing your lifestyle.

LIPOSACTION risks & complications

Liposuction risks depend very much on health condition and client diseases and following conditions should be checked before planning liposuction procedures:

• High blood pressure;
• Diabetes (any type);
• History of heart problems;

• Different types of allergy including allergy to specific medications;
• Pulmonary problems (shortness of breath, air pockets in bloodstream);
• Smoking, alcohol and/or drug abuse.

In general liposuction performed by an experienced doctor in a properly equipped facility is safe but there are some risks which should be discussed before making final decision. Usually risks are increased if liposuction covers large area and/or many areas. Risks correlated to liposuction include:

• Post-operation swelling, bruising, soreness, and numbness in and around the treated areas;
• Post-operation scarring and/or irritation (around the incision sites, skin surface may be irregular, asymmetric, or even "baggy," especially in older people);
• Shock (usually when not enough fluid is replaced during the surgery);
• Fluid overload (usually from the procedure);
• Infections;
• Bleeding and/or blood clot;
• Fat embolism – when tiny globules of fat moved to the bloodstream block blood flow (very dangerous!);
• Nerve, skin, tissue, or organ damage or burns from the heat or instruments used in liposuction;
• Permanent color changes in the skin;
• Asymmetric fat removal (technical and/or qualification problems);
• Drug over-reactions and/or overdose from the lidocaine used during liposuction.

Although death is very rare with liposuction, it can happen. If you are having a large amount of fat removed, are obese, or have health problems, your risks go up.
Special attention should be paid to:

• Your health indicators;
• Excessive blood and fluid loss, leading to shock;
• Fat clots or blood clots, which may travel to the lungs (pulmonary embolism) and become life-threatening;
• Pulmonary edema (buildup of fluid in the lungs) - most likely to occur when a large volume of fluid is injected into the body;
• Post-operation infections;
• Toxic reaction to the injected solution (lidocaine toxicity), especially if large areas or many areas are treated at one time;
• A puncture into the cavity containing the abdominal organs or damage to an organ such as the spleen.

Liposuction should not be done in people who have severe heart problems, blood-clotting disorders or during pregnancy.