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Liposuction
Liposuction is
a procedure that can help sculpt the body by removing unwanted fat from
specific areas, including the abdomen, hips, buttocks, thighs, knees,
upper arms, chin, cheeks and neck.
Details:During
the past decade, liposuction, which is also known as "lipoplasty" or
"suction lipectomy," has benefited from several new refinements. Today,
a number of new techniques, including ultrasound-assisted lipoplasty
(UAL), the tumescent technique, and the super-wet technique, are helping
many plastic surgeons to provide selected patients with more precise
results and quicker recovery times.
Although
no type of liposuction is a substitute for dieting and exercise, liposuction
can remove stubborn areas of fat that don't respond to traditional weight-loss
methods.
Procedure:
There are several liposuction techniques that can be
used to improve the ease of the procedure and to enhance 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 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, your surgeon
will then move on to the next area, working to keep the incisions as
inconspicuous as possible.
Technique
variations The basic technique of liposuction, as described above, is
used in all patients undergoing this procedure. However, as the procedure
has been developed and refined,
several
variations have been introduced.
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
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.
Ultrasound-Assisted
Lipoplasty (UAL). This technique requires the use of a special cannula
that produces ultrasonic energy. As it passes through the areas of fat,
the energy explodes the walls of the fat cells, liquefying the fat.
The fat is then removed with the traditional liposuction technique.
Length:
The time required to perform liposuction may vary considerably, depending
on the size of the area, the amount of fat being removed, the type of
anesthesia and the technique used. On average 1 to 2 hours or more.
UAL : 20-40 percent longer than traditional liposuction.
Anesthesia: Various types of anesthesia can be used
for liposuction procedures including local, epidural or general.
In/Outpatient:Liposuction is usually performed on
an outpatient basis. Extensive procedures may require short inpatient
stays.
Side-Effects
/ Risks: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.
Ultrasound-Assisted
Lipoplasty (UAL). This technique requires the use of a special cannula
that produces ultrasonic energy. As it passes through the areas of fat,
the energy explodes the walls of the fat cells, liquefying the fat.
The fat is then removed with the traditional liposuction technique.
The
combination of these factors can create greater hazards for infection;
delays in healing; the formation of fat clots or blood clots, which
may migrate to the lungs and cause death; excessive fluid loss, which
can lead to shock or fluid accumulation that must be drained; friction
burns or other damage to the skin or nerves or perforation injury to
the vital organs; and unfavorable drug
reactions.
There
are also points to consider with the newer techniques. For example,
in UAL, the heat from the ultrasound device used to liquefy the fat
cells may cause injury to the skin or deeper tissues. Also, you should
be aware that even though UAL has been performed successfully on several
thousand people worldwide, the long-term effects of ultrasound energy
on the body are not yet known.
In
the tumescent and super-wet techniques, the anesthetic fluid that is
injected may cause lidocaine toxicity (if the solution's lidocaine content
is too high), or the collection of fluid in the lungs (if too much fluid
is administered).
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.
Recovery:
Back
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 or UAL may decrease post-operative bruising and swelling.
Results:
You will
see a noticeable difference in the shape of your body quite soon after
surgery. However, 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.
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.
Frequently
Asked Questions:
Q. Who
are the best candidates for Liposuction ?
A. The
best candidates for liposuction are normal-weight people with firm,
elastic skin who have pockets of excess fat in certain areas.
Q. With
all of the variations in liposuction, how will I know which is best
for me?
A. Individuals
considering liposuction often feel a bit overwhelmed by the number of
options and techniques being promoted today. However, your plastic surgeon
can help. In deciding which is the right treatment approach for you,
your doctor will consider effectiveness, safety, cost and appropriateness
for your
needs.