¬ LIPOSUCTION

LIPOSUCTION – FAT REDUCTION

Liposuction also called as lipoplasty, fat suction or fat reduction is based on removing the excessive localized fat(tummy,arms,legs,hips,belly,face etc.) by using specific canulas to attain a balanced body contour. First defined in the early 80s,commonly practiced in the 90s andit  has sit on a firm ground in 2000s. It is still being used by high quality plastic surgeons safely. This procedure is also launched with different names like  liposhaping, liposculpturing to attract patients attention. All these fancy definitions imply standard liposuction.

Liposuction is not a mean used for losing weight. It is applied in order to reshape body contour by abducting excessive fat deposits from certain areas that form disproportionate appearance. Localized fat areas vary depend upon whether you are a man or woman. Woman frequently tends to carry excessive fat cells under belly,on the flanks, hips, inner tighs and knees while man tends to carry excessive fat cells on the love handles, tummy and breasts(gynecomastia). Often excessive fatty areas are hereditary and typically it is hard to reduce by doing  exercises and diet.  Liposuction responds well in this case. 

An adult man tends to carry body fat in his chest, abdomen and buttocks, producing an "apple" shape.

An adult woman tends to carry fat in her breasts, hips, waist and buttocks, creating a "pear" shape.

Are you a good candidate for liposuction?

If you have excessive localized fat on any of the areas mentioned below that makes your body look uneven then you are a good candidate for liposuction.

Abdomen and waist

Back

Hips, inner tighs, inner knees

Tighs and ankles

Face, chin and neck

Chest and surrounding(underams)

Breasts(gynecomastia)

Liposuction  can be applied at all ages. Liposuction is also used for reducing fat on breasts in adult and young men which is called gynecomastia .

Pre-Op Initial Consultation 

If you are considering liposuction surgery you should seek an experienced plastic surgeon and consult with the doctor. 

In this consultation you should clearly tell your complaints and expectations about  this surgery.Over the couse of the consultation,  your doctor will listen to you closely and evaluate the localized fat mass ,skin elasticity and get your expectations. This is crucial for a successful liposuction result.Then  he/she will take notes for surgical plans and mark the corncerning areas. Considering your expectations and surgical examination,  your doctor will offer you the best and tailor made option and give you detailed information that includes what should you realistically expect from the surgery. Your plastic surgeon  will explain the surgical method, anesthesia ,the place of operation (hospital) . He will provide  complete instruction  on pre and post operative  care. Also he will    give you information about the risk and potential complications of the surgery . 

Before deciding  liposuction  surgery ask all the questions you have in your mind until you get satisfactory answers and fully comprehend . In this consultation you may also get a quote. Based on the whole information you got you may finalize  your decision.

Once you decide to go with the procedure you will be asked  to have several blood tests done . If  test results are normal, the surgery time, date  and  place will be  determined.

How will I prepare for the surgery?

You should avoid medicines like asprin and anti-inflammatory as they may cause bleeding. Before the operation you will be advised again. Vegetables and fruits like almond, apricot, cherry, strawberry, grapes, garlic, tomato and cucumber should be consumed as little as possible because they contain salicilate which is active ingredient of asprin two weks before the surgery. Moreover, herbal medicines and vitamins should be delimited.

How will be the day  of surgery?

Following registration in the hospital you will be smoothly transferred to your room. Your surgeon and anesthesist will come over to your room before the surgery . Your surgeon  will mark your breast as he /she planned . Also  anesthesist will inform you about the anesthesia and ask related  questions. Before going to operating room (OR) , a sedative  injection  will be administered.   It will help you to relieve the anxiety and the excitement related to surgery which is very common.  In the operating room, anesthesia will be applied. Liposuction can be  performed under general anethesia or local  anesthesia with intravenous sedation. But mostly general anesthesia is preferred. Under general anesthesia you will be sleeping during the  surgery. Your doctor will offer you the best choice that fits your case. 

How is liposuction performed?

Liposuction also called as lipoplasty, fat suction or fat reduction is based on removing the excessive localized fat (tummy, arms, legs, hips, belly, face etc.) cells by using specific canulas to attain a balanced body contour.Canula is attached with a plastic tube to device that pressurize 760mmHg.The pressure provides fat deposits to liguify and sucked. Canulas are inserted through incisions less than 1cm which are hidden in the skin creases and the body contours. First, special solution for liposuction is delivered under the skin through incisions and wait for 15-20 min. While the solution helps fat cells to dissolve,  it prevents bleeding by constricting the veins.Then with the help of canulas attached to vacuum device, dissolved fat cells are removed by suctioning. The balance of fat amount to be removed is the key to a succesful liposuction surgery. Likewise, remaining amount of fat is also important. To avoid problems in liposuction the main principle should be  as folllows:‘how much fat you leave inside matters rather than how much fat you suck out for a high quality liposuction’. If this principle is pursued proportion and smooth outcome can be achieved.After liposuction a special corset is dressed.

Comparison of common liposuction methods :

Ultrasound assisted liposuction(UAL),includes breaking up fat deposits by emitting ultrasound energy and suctioning out with standard liposuction method. First used in the early 90s in Europe and in 1997 in the USA, however, (Maxwell GP. Ultrasound-assisted lipoplasty:a clinical study of 250 consecutive patients. Plastic Reconstr. Surg. 101:-189-202,1998) due to great complication of risks American plastic surgeons occasionally performs the procedure. 3rd generation Vaser Liposelection  device is improved. With Vaser liposuction device, it is found that nerves and veins are minimally damaged while breaking up fat depositts.

In recent years, Slim Lipo or Smart Lipo laser devices are developped.The laser system works by emitting different wavelengths to fat layers to break up and liquiefy.As this method is performed in small areas the liquid is sucked by the body.However, in large areas liquified fat cells should be sucked out with standard liposuction.

Whether laser or vaser liposuction method is used on the large areas the surgery must be combined with standard liposuction. The advantages and disadvantages over one on another should be discussed.

That is why, as pioneering liposuction surgeon Dr.Yves-Gerard Illouz written’ While The new does not always mean the best, the standard and the classic does not always mean worthless.’ Every method has its own advantages and disadvantages. Considering all the factors your surgeon will offer you the best choice.

The first days of the surgery

When the surgery is finished you will be taken to your room. You will be checked here and necessary medications like painkillers and antibiotics will be given.Couple hours after the surgery you are allowed to eat liquid food. You will be asked to stand up and take a walk in short periods. Depending on your case you may be discharged on the same day or the following day. You will notice the positive difference in your body contour depending on your body structure.After couple of days you will  move comfortably. You should avoid exerting power, bending your body, doing strenuous exercises and carrying heavy things.Resting bad for couple of days will help you manage initial healing. You will be asked to dress up your special corset regularly that will help to fade post-op swelling and pain also your body to be reshaped. In the 3-4 days swelling also called as eudema will make a peak and dissipates very fast. Day by day you will feel and look better.When done right, bruising occurs very occasionally.If there is bruising it will go off within a week. Initial healing process varies depending on the person.

 When you take  pain pain killer regularlay, it will work and you won’t feel discomfort.

Dressings on the incison sites may be changed on the 2-3 day post-op. After dressings renewed you may take a shower.

When will I be able to resume normal activities?

In a couple of days you may resume your work. As with all examples you may begin your exercises within 1-2 weeks or later.Initial healing process depends on the extent of surgery.

When will I see the liposuction results, when will the swelling goes off?

Related to your body structure you will be able to see the slimming and positive difference immediately after the operation. However, there will be swelling or eudema on the liposuction areas. On the 3 days post op swelling also called as eudema will make a peak and dissipates very fast. As a rule 50% of swelling dissipates on the first month post-op,25% on the second month post-op and remaining 25% on the third month post-op.Final result will be clear 3 months after the surgery.In this process being patient and keeping fit is important.There should be at least 3 months interval between two liposuction surgeries. 

How long will the result last?

As long as you keep your ideal weight stable and live a healthy lifestyle the result will be permanent.A balanced diet,regular exercises will help you maintain your new look.

Keeping contact with your surgeon

Your surgeon will advise you on follow up visits to check periodicaly and see the results .During initial healing period, follow up visits are important to avoid potential problems and resolve them.For further questions and concerns you are always encouraged to ask your surgeon after the surgery. Your surgeon will support you at every step of surgical process.

Prof. Dr. Muhitdin Eski