Body Contouring – Liposuction

What Is Liposuction?

In our image-oriented society, the body we associate with youth and beauty is one that is slender, sculpted, and well-proportioned. Often, as a function of increasing age and decreasing exercise, we begin to accumulate a few extra pounds each year, and before we know it, the person we see in the mirror no longer resembles the lean and svelte image we remember from our recent youth. Sometimes, the problem is not the weight we see on the scale, but the disturbing shape we see in our slowly-expanding waistline or hips. Unfortunately, our hectic modern lifestyle may prevent us from exercising regularly or eating a healthy, low fat diet. Occasionally, hereditary factors are the culprit, conspiring to keep us from resembling the ideal, and we believe we are destined to live with moms hips or dads double chin. Many of us have experimented with various diets and exercise routines to combat these areas of unwanted fat, most often to no avail. If you have localized areas of unwanted fat that you simply cannot lose, the problem may be genetics and lifestyle
– Liposuction may be the answer.

Liposuction, also called lipoplasty, is a surgical procedure that removes bothersome, localized, disproportionate deposits of excess fat from specific areas of the body, face and neck. Liposuction can be used to slim the hips and thighs, flatten the abdomen, shape the calves and ankles, or eliminate a double chin. Liposuction is the most popular cosmetic surgical procedure performed today. Because of the relative simplicity of the concept, “vacuuming” of unwanted fat from areas of the body, it has been adopted by many medical practitioners without formal training in Plastic Surgery. Liposuction may not be the appropriate procedure choice in all cases, and there are limitations as to the amount of fat that can safely be removed in a single operation. Liposuction is not a substitute for weight control. It is important to know the proper indications for the procedure, to be able to discuss alternatives, and to manage potential risks.

Am I A Candidate?

Body contours made irregular by excess fat accumulation can be improved by Liposuction. Generally, these areas are not responsive to diet or exercise, and are persistent even when you are at your ideal weight. The best results with Liposuction are obtained in younger patients in whom the skin elasticity remains resilient, so that the skin will smoothly re-contour following the procedure. In some older patients, or in those with more long-standing localized fatty excess which has stretched the skin for a longer time period, the skin may be inelastic, and a skin tightening procedure (Abdominoplasty or Body Contouring) may be required. Liposuction cannot correct contours that are irregular for other reasons, such as muscle weakness or hernia, and it is not applicable in cases where there is excessive skin laxity (for example, the abdomen after multiple pregnancies) or “cellulite”. However, combined with additional procedures, Liposuction can often correct these other deformities with good results. Liposuction can also be used to treat a condition called Gynecomastia, or Male Breast Enlargement, where there is localized accumulation of excess fatty and breast tissue in teen or adult males.

• The areas that respond well to Liposuction include:
• Cheeks, jowls, and neck
• Upper arms
• Breast or chest areas
• Back
• Abdomen and waistline
• Hips and buttocks
• Inner and outer thighs
• KneesCalves and ankles

Liposuction is a Body Contouring technique, not a method of surgical weight reduction. Even in large-volume Liposuction, although there is usually a noticeable and often dramatic improvement of the body contours, there may be relatively little change in the patients weight post-operatively, since fat is less dense (lighter in weight) than a comparable volume of water. Liposuction is not effective on diffuse, generalized excess fatty deposits. Dr. Cambre advises patients that a medically-supervised weight reduction program is most beneficial in such cases, in order to arrive at or near their ideal goal weight before Liposuction is done. Liposuction works hand-in-hand with a healthy, low-fat diet and a program of regular exercise, to restore your shape, or to create the shape you’ve always dreamed of, minus the unwanted bulges that never seem to go away, even with your best efforts at diet and exercise.

Your Consultation

At the time of your consultation with Dr. Cambre, you will be asked to point out the areas which concern you and which you would like to see improved. It is important to have realistic expectations about what can (and cannot) be achieved by the procedure. Liposuction is most successful in people of normal body weight with good skin tone who have isolated, localized unwanted fatty deposits. It is not a treatment for obesity, and usually, your weight will not change markedly following the procedure. Rather, the procedure will result in improvement of contour. If weight gain occurs following Liposuction, the resulting fat may be deposited in areas that have not been treated. The procedure can be repeated, if necessary.

A variety of factors can affect the results: physical condition, genetic makeup, diet, exercise, smoking, alcohol intake, and skin elasticity. Dr. Cambre will also carefully evaluate your general state of health. Any underlying conditions which may compromise your result, and any medications you may be taking, should be discussed in detail. Dr. Cambre will estimate the amount of fat that should be removed from each individual area of concern, in order to achieve the optimal result.

The Procedure

Liposuction is usually done under light general anesthesia on an outpatient basis in a surgical center, or rarely in a hospital setting. Small, discreet incisions, hidden in natural skin folds or placed as inconspicuously as possible, are placed adjacent to the areas to be treated. A cannula (small metal suction tube) of variable size (2.5 – 5 millimeter) is attached to a surgical vacuum machine or syringe, inserted through the small incisions, and directed below the skin into the fatty deposits requiring treatment. The procedure may take an hour or more, depending on how many areas will be treated.

Liposuction Methods

“Tumescent” technique — local anesthesia, wherein a dilute solution of local anesthetic is infiltrated under pressure into the fatty areas to be liposuctioned, is used in certain circumstances, either with or without a sedative. Small, localized areas can be treated with tumescent local anesthesia alone, but the injection of the local anesthetic solution itself may be uncomfortable or painful.

“Wet” and/or “Super-wet” technique — local anesthesia is used in most cases, and involves the use of lesser quantities of similar dilute solutions of local anesthetic, usually in conjunction with light general anesthesia or intravenous sedation, to diminish the blood loss associated with Liposuction, and to provide long-lasting pain relief both during and after the procedure. Because the local anesthetic solution is infiltrated after the sedation or general anesthetic, the injections themselves are painless. This is the usual technique used in cases where Liposuction of multiple areas is planned.

In addition to traditional vacuum Liposuction, there are other types of instrumentation which can be useful in certain situations:

Power-Assisted Liposuction (PAL) — involves the use of a special mechanical hand piece, which produces a rapid reciprocating movement of a standard-type cannula tip (similar to a sewing machine). Used in areas of dense or fibrous fat, or in secondary Liposuction cases, passage of the cannula is easier, and the fat is simultaneously vacuumed away, as in traditional Liposuction.

Ultrasound-Assisted Liposuction (UAL) — involves use of a specialized hand piece and cannula tip connected to an ultra-high-frequency sound wave generator. Vibrations above the range of human hearing (ultrasound) are transmitted to the cannula tip, and fat in the areas of treatment is liquefied and emulsified by bursting of the cell membranes. A separate cannula and low-pressure vacuum are then used to remove the liquefied fat emulsion. This technique is also applied in difficult or secondary cases, but has somewhat greater associated risks.

Occasionally, aspirated fat is harvested for Autologous Fat Grafting. In this procedure, the fat taken from an area of excess is transferred to an area where you desire increased fullness, such as the lips, other lines in the face, or areas of cellulite dimpling. Many patients ask if this fat can be transferred to the breast; however, fat transfer to the breast is not advisable, because it occasionally can produce small areas of calcification that resemble early signs of breast cancer on mammograms. Please let us know if you wish to have some of your fat harvested for transfer to another area.

Dr. Cambre will select the appropriate technique and instrumentation necessary in your particular case, to achieve the result you desire.

Options and Alternatives

Liposuction alone will not address laxity of the skin in the treated areas, and in fact may worsen the appearance of these areas. In such instances, an alternative body contouring surgical procedure may be required, most commonly in conjunction with liposuction of the involved area(s). For excess, lax skin of the abdomen and hip areas, Abdominoplasty or Lower Body Lift may be required. Loose skin of the upper arms may require Brachioplasty (Arm Lift), and sagging skin of the inner thigh region may require Thigh Lift. A double chin may require Facelift or Neck Lift in order to achieve the desired outcome. Dr. Cambre will discuss your options and the relative benefits and risks of each procedure as they pertain to your anatomy and your specific goals, to help you decide which option is best for you.

Risks

Although most patients have uncomplicated recovery after liposuction, there are occasional problems or complications which may occur. Permanent problems are quite rare. Potential short-term complications include bleeding, infection, and reactions to anesthesia. Cosmetic complications include contour irregularities such as depressions or wrinkling of the skin, discoloration of the skin, asymmetry when comparing one side to the other, scar tissue, tape burns, and collections of blood (hematoma) or fluid (seroma) under the skin. Additional surgical procedures may be required to correct these complications, and there may be additional financial expense, loss of income, and inconvenience to you. Uncommon complications include loss of sensation or movement in a body area, skin breakdown or loss requiring skin graft or reconstruction, and fat embolism or blood clots in the lower leg veins which may travel to the lungs (pulmonary embolism). Serious infection, or shock requiring hospitalization and blood transfusion, are very rare. Some bleeding and fluid shift is expected during Liposuction. Because of this, to maintain the safety of the procedure, there is a limit on how much fat can be removed at one time. If Dr. Cambre anticipates that large volume Liposuction (beyond the safe limit of a single operation) is required to achieve your goals, this may necessitate that the overall operation be divided into multiple stages separated by recuperation intervals of several weeks or months, in order to safely accomplish the desired goal without the need for blood transfusion.

Recovery

Your recuperation from Liposuction surgery is relatively easy. Initially, you may feel somewhat stiff and sore. The day after surgery, you should be up and walking around to promote normal circulation. You should expect a fair amount of swelling, possibly to the point where the treated areas appear unchanged or heavier than before surgery. There most likely will be some bruising in the two weeks following your procedure, which may be extensive and may appear to involve areas which were not treated as well. You will wear special elastic compression garments provided to apply pressure, minimize swelling and provide support while healing. These garments also assist in retraction of the skin, and although they may be somewhat hot and uncomfortable, they must be worn continuously for the first few weeks after surgery, except when showering, in order to maximize your cosmetic outcome. Stitches will be removed in approximately one week.

You will be ready to return to office work in 3-5 days, and more strenuous activities at 10-14 days. You may increase your activity daily until full activity is resumed at 2-4 weeks. Avoid the sun until all bruising has subsided. A sunscreen should be used routinely; it is easy to get sunburned during recovery because of temporarily-diminished sensation.

Your New Look

Your results will be recognizable almost immediately after Liposuction, and will continue to improve gradually as the swelling subsides. The unwanted and unflattering bulges that prevented you from wearing your favorite styles of clothing will be gone, and you will have a new, slimmer contour.

With your diligent attention to a healthy diet, moderate exercise, and a weight management program, the results of Liposuction are long-lasting or permanent. In the event of weight gain following your surgery, you might note a more generalized, more even distribution of excess fat, rather than re-accumulation in the previous problem areas where treatment was performed. If necessary, a touch-up procedure can be done, to further improve the areas of Liposuction, or you may find that you wish improvement of other areas at a later time.

Our patients find Liposuction to be a very satisfying procedure to remove those unwanted areas of fat that just won’t go away no matter how hard you try. Call for your consultation with Dr. Cambre today, and get rid of those unwanted bulges that are hiding the “slimmer you” within.

Frequently Asked Questions

Q: What is the maximum volume of fat that can be removed in one operation?

A: The maximum safe volume of fat to be removed during Liposuction is approximately 5 liters. The actual safe volume may be greater or less than that amount, depending upon the amount of bleeding observed, or other factors such as changes in the patients vital signs during the procedure.

Q: Is a blood transfusion required for patients undergoing Liposuction?

A: No. If it is anticipated that there may be a greater risk of blood loss during the procedure (secondary liposuction, large volume liposuction in men), Dr. Cambre may suggest that you donate a unit of your own blood (Autologous Blood), which can be given to you during the procedure. In general, blood transfusions (even Autologous Blood) should be discouraged, to avoid the risk of transfusion errors and transmission of blood-borne illnesses.

Q: How much weight will I lose after Liposuction?

A: Liposuction is designed to improve body contours, rather than for weight loss. In most cases, a patients weight decreases only minimally after the procedure, but the change in shape and correction of unwanted contours is often dramatic.

Q: Will my skin sag after Liposuction?

A: If the skin has sufficient elasticity and resilience, it should shrink and contract nicely over the areas where the fat has been removed. This is generally the case in younger patients and those in whom the areas of excess fat have not been present for an extended length of time. If the skin has been stretched beyond recovery by years of localized fatty excess, Liposuction may need to be combined with another Body Contouring procedure to remove the excess skin.

Q: If I gain weight after Liposuction, will the fat be deposited in other locations?

A: Since the fat deposits your body previously used preferentially to store excess fat have been reduced, you may find that fat accumulates in other areas of the body after Liposuction. Generally, this tendency of the fat to shift to other areas is minimal, but you should obviously avoid regaining the weight!

Q: When can I shower or bathe after Liposuction?

A: You may shower after the first office visit / dressing change, generally within 24-48 hours after surgery. You must not bathe or immerse the incision sites under water in a bathtub, hot tub, swimming pool, etc. until the incisions are completely healed. Dr. Cambre will instruct you when bathing is permitted.

Q: How long do I need to wear the elastic compression garment after Liposuction?

A: The elastic compression garment is used to diminish the amount of swelling and bruising in the treated area. It also prevents accumulation of excess fluid (serum or blood) under the skin, and helps to maintain the contour of the treated area. It should be worn continuously, 24 hours a day, 7 days a week (except while showering) for the first 3-4 weeks. After that time, it can generally be used for support and comfort during the daytime only, for an additional 3 weeks.

Q: When can I resume driving?

A: Most patients may resume driving after approximately 48-72 hours. You should not drive if you are taking narcotic pain medication, sedatives, or muscle relaxants.

Q: When can I resume exercise?

A: Patients are encouraged to begin walking immediately after surgery. You may resume more strenuous walking on a treadmill, or mild upper extremity weight training after 7-10 days. Most patients resume full, unrestricted exercise after approximately 4 weeks.

Q: When can I return to work or normal social activities?

A: Most patients are able to return to work or resume normal social activities after 3-4 days. If your work involves sitting for extended periods, you are encouraged to take frequent breaks to stand and walk, in order to promote circulation and deep breathing. You will need to wear loose-fitting clothing which will hide the presence of your compression garments, as long as these are necessary.

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