Liposuction is a surgical technique
that improves the body’s contour by removing excess fat
from fatty deposits located between the skin and muscle. Body
sculpturing by liposuction is literally a dream come true. Localized
accumulations of fat, which are often hereditary and frequently
impossible to eliminate by exercise or dieting, can now be removed
permanently by liposuction surgery, never to plague you again.
Liposuction involves the use of a small stainless steel
tube called a cannula. Connected at one end to a specialized suction
pump, the cannula is inserted through tiny skin incisions. The
removal of fat is accomplished as the suction cannula creates tiny
tunnels through the fatty layers. After surgery, these tiny tunnels
collapse, resulting in an improved body contour. Back to Top
The body fat of an adult tends
to increase gradually over the years. After the age of 30, an
individual tends to add fat according to a genetically predetermined
pattern. This fat distribution is often resistant to exercise
and dieting. An example of genetically predetermined fat distribution
that is resistant to dieting and exercise is the fat that appears
on the abdomen and hips of a woman after pregnancy. For many people who
have inherited the tendency to accumulate excessive fat, liposuction
is the only realistic means of significantly changing the body’s
silhouette. Back to Top
The most frequently treated areas
in women are the abdomen, hips, thighs, knees, calves, ankles,
and beneath the chin. In men, who comprise about 25% to 30% of
patients who undergo liposuction, the most commonly treated areas
include the love handles, abdomen, breasts, and the neck and
chin area. Back to Top
Fat cells that are removed by liposuction do not grow
back. As long as the patient does not gain an excessive amount
of weight, the new, more pleasing silhouette is permanent.
A woman who always tends to put
weight on her thighs and knees, will find that after liposuction,
these areas are less likely than other areas to accumulate fat
when she gains weight. In fact, a number of patients have had
liposuction and subsequently gained weight. In these patients,
the areas originally treated by liposuction generally maintain
their new desirable silhouette, whereas areas not treated by
liposuction are the sites of new deposits of fat. Back to Top
The Tumescent Technique of liposuction was developed
in 1985. The Tumescent technique involves the use of large volumes
of a dilute solution of lidocaine (a local anesthetic) in combination
with the vasoconstrictive drug, epinephrine, which shrinks capillaries.
Local anesthesia used in the
Tumescent technique for liposuction is so effective that patients
no longer need intravenous sedatives, narcotic analgesics, nor
general anesthesia. This technique is now considered the safest
form of liposuction for removing very large amounts of fat because
there is virtually no blood loss. Not only has the Tumescent
technique proven to be safer than the standard technique using
general anesthesia, but it also has proven to be less painful,
has minimal post operative recovery time, and produces
optimal cosmetic results.
With the Tumescent technique,
infiltrating the local anesthesia is associated with minimal
discomfort. Once the area has been completely numbed, surgery
in that area is essentially painless. In addition, because the
numbness remains in the treated area for more than 12 hours,
there is no pain immediately after surgery. Back to Top
As with any surgical procedure, liposuction is associated
with certain common side effects such as bruising, swelling, and
temporary numbness. Although irregularities of the skin are possible
following liposuction, this side effect is minimized by the Tumescent
technique. When larger cannulas are used, occasionally there are
patients with an irregularity of the skin. Since smaller, microcannulas
became available, noticeable irregularities are very rare. Because
of the slow resolution of post liposuction swelling, the ultimate
results following liposuction usually require 12 to 16 weeks to
become fully apparent. Nevertheless, patients can usually see dramatic
improvements within two to four weeks after surgery.
Although the results of liposuction
are often quite spectacular, it is not realistic to expect perfection.
Liposuction of the thighs, while improving the silhouette, does
not necessarily eliminate the subtle “puckering” of the skin that is
often referred to as “cellulite.” Liposuction with
the Tumescent technique does reduce the degree of cellulite but
it is unlikely to eliminate it. Rare problems that can potentially
occur with any surgical procedure include infections, bleeding
and nerve injury, The Tumescent technique, however, minimizes these
risks. Back to Top
Infections are extremely rare,
regardless of whether or not the anesthetic technique is that
of general anesthesia or local anesthesia. Although there have
been reports in the medical literature of patients who have had
serious infections following liposuction surgery, to the best
of our knowledge, there have never been any patients who have
had an infection following Tumescent liposuction performed using
only local anesthesia. Lidocaine,
the local anesthetic that is used for the tumescent technique,
kills bacteria. With the Tumescent technique the areas that are
being treated surgically are those same areas that will receive
the local anesthetic that kills bacteria. Back to Top
Because of the significant decrease
in swelling and decrease in inflammation and pain after surgery,
patients are able to return to normal physical activities very
soon after the procedure. There is no limitation of physical
activity other than what common sense would dictate. Some patients
are able to return to jogging, golf, or light aerobic exercise
within a day or two after surgery. Some patients do find the
soreness after surgery to be more significant than others, but
on the average, most patients are surprised at how quickly they
are able to return to normal activity. Back to Top
Because very small cannulas are
used with the Tumescent technique, it permits a more delicate
and gentle approach to liposuction as the surgeon can control
the direction and position of the cannula with much more accuracy.
This results in a greatly reduced risk of inadvertently approaching
the undersurface of the skin too closely and unintentionally
causing skin irregularities. Further, the use of very small
cannulas enables the surgeon to make such small incisions that
no stitches are used. The wounds heal by themselves and virtually
disappear over time.
By not using stitches to close
skin incisions, the rate of healing is faster. Another benefit
of not stitching the incisions closed is that, after the procedure,
the open incisions permit easy drainage of the slightly blood-tinged
anesthetic solution. This has a dramatic effect in minimizing
bruising. Most patients notice that bruising is almost entirely
absent after surgery. Back to Top
