COSMETIC SURGERY
LIPOSUCTION
Liposuction removes topical fat and it is typically performed with a nozzle activated at negative pressure. The bodyweight increases due to fluid retention and fat accumulation in the fat cells. The number of those cells is fixed throughout one’s lifetime, but they increase in volume. Liposuction reduces the number of fat cells in the operated area; therefore, the results are stable and permanent.
The incisions made in the nozzle’s point of entry are small, up to 1 cm (0.4 in.), and they disappear in a short while. Liposuction can be performed on any part of the body, but most of the fat usually accumulates in the buttocks, thighs, knees, ankles, calves and abdomen. It aims at enhancing the body’s shape, but not reducing bodyweight. The body’s shape after the procedure is stable, irrespective of whether the patient puts on or loses weight. The removal of excess fat, mainly from the thighs, may cause skin laxity. The greater the volume of fat removed the more lax the skin becomes. On the other hand, if the patient’s skin is quite elastic, the laxity is not so prominent. Moreover, the younger the patient, the more elastic the skin, so again there is minimal laxity. So ideally the patient should be young with topical fat, as opposed to older with fat distributed all over the body. The major problem of cellulite, which often troubles a large number of patients, cannot be treated with liposuction, while it may even become worse in some cases. Physiotherapy programs with special massages postoperatively may help reduce cellulite.
The procedure is simple and lasts from 30 minutes to 1 hour, depending on the areas that need liposuction. Patients may receive general anesthesia, while in some cases they may receive local anesthesia, depending on the size of the area that needs to be treated. An elastic compression garment has to be worn immediately after the procedure to reduce postoperative swelling. This garment has to be worn for 20 days and can be removed only for the patient to have a quick shower. The patient is discharged 2-3 hours after the operation, as soon as the influence of the anesthesia has worn off. If a very large quantity of fat is removed during the procedure, then the surgeon may keep the patient in hospital overnight in order to have their fluids replenished intravenously. On the fourth day, patients may remove the elastic garment and the gauzes for a shower, dry themselves, wear the garment again and visit their surgeon for the first checkup. The sutures are removed on the seventh day.
Immediately following the procedure, intense bruising appears in the areas where the liposuction was performed, while patients experience a burning sensation. Seldom do patients experience intense pain that may require painkillers for the first few days. The bruising starts to fade on the seventh day and disappears in 20-25 days. Patients may start exercising on the tenth day.
Liposuction is a safe procedure and studies on millions of liposuctions worldwide have shown very few cases were the patients have become ill as well as negligent mortality rates, provided these procedures were performed in accredited medical clinics by expert plastic surgeons.
Various systems and devices are being designed constantly to assist the original liposuction technique. At times, they may be somewhat useful, while at others, they do not render the desired effects. Surgeons have to exercise extreme caution. These efforts aim at facilitating an already simple technique and raising market interest. Ultrasound systems that split the cell membrane of the fat cells and prevent bruising have not been widely accepted by plastic surgeons. Possible complications and skin necrosis have discouraged the widespread use of this method. Filtering and vibration systems in the liposuction nozzles promising faster and more effective liposuction have also started being promoted by medical supply companies. Lately, the use of radio frequencies during liposuction promises to minimize skin laxity, but it reappears if the skin was originally quite lax. Personal experience tends to accept this promise and the technique is being adopted all the more often.
Useful Facts about Liposuction
Length of surgery: 30 min – 45 min
Anesthesia: General, local or epidural
Duration of Hospitalization: ODC (one-day clinic) to 1 night stay
Return to normal activities: In a few days (4-5)
Postoperative care: First dressing change on the second postoperative day. Shower on the fourth postoperative day. Stitches removed on the sixth postoperative day. No restriction on physical activities. Compression garment is worn for 20 days.