Liposuction/Liposculpture Cosmetic Surgery
Liposuction is also known as lipoplasty, liposculpture suction lipectomy or, more commonly, as "lipo". It is a cosmetic surgery that is used to remove fat from many different body sites. Liposuction is a wonderful tool for body sculpting and can be used to treat problem areas such as the neck, thighs, buttocks, thighs, arms and abdomen. Lipo is most appropriately used as a sculpting tool, however, and is not a substitute for weight loss. It can certainly help but removing excess amounts of fat is highly dangerous and not a safe way to lose weight. Think of liposuction as a shaping tool and not as a weight loss tool.
Good Candidates for Liposuction
A good candidate for liposuction surgery is a person who is over 18 years old, who is not a smoker, and is in general good health. Diabetes, infection, heart or circulatory problems and certain medication regimes are contraindicated conditions for liposculpture. Your surgeon will also get a mental profile to make sure that your reasoning is sound. Liposuction will not result in a pleased patient if the expectations that they have are not reasonable or if the reasons for getting the procedure done are unhealthy. Liposuction should be something you are considering for your own benefit and not for the pleasure or expectations of others.
Techniques
Liposuction, explained in its simplest terms, is removing fat via a cannula (a hollow tube) and an aspirator (a vacuum). The different techniques developed for this basic procedure have to do with the amount of fluid injection and the mechanisms by which the cannula works.
- Suction-assisted liposuction (SAL) - this is the standard method of liposuction surgery. A small cannula is used and inserted through a small incision. This is then attached a vacuum device. The surgeon pushes and pulls it in a forwards and backwards motion, carefully breaking through the fat layer and drawing out the fat cells.
- Ultrasound Assisted Liposuction (UAL) - Ultrasonic liposuction uses a specialized cannula to transmit ultrasound vibrations within the body. The vibration bursts the walls of the fat cells, liquefying the fat and making it easier to suction out. UAL is a good choice for treating more fibrous areas, such as the upper back. This technique takes longer than traditional liposuction but not longer than tumescent liposuction. The technique also includes slightly less blood loss but also seems to have a slightly higher association with seroma post-surgery.
- Power-assisted liposuction (PAL) - this technique uses a specialized cannula that has a mechanized movement. This means the surgeon doesn’t have to make as many manual movements but it otherwise similar to traditional SAL.
- Twin-cannula assisted liposuction (TCAL or just TCL) - A tube within a tube style specialized cannula pair is used so that the cannula which aspirates (sucks up) the fat does not impact the patient’s tissue or the surgeon’s joints with each forward stroke. These cannulas do not get hot, eliminating concerns about friction burns and are quite efficient, removing most of the manual labor from the procedure.
- Tumescent Liposuction - this procedure involves the injection of large amounts of saline solution mixed with Lidocaine into the fatty tissue. This is a favored method for liposuction as it provides the most amount of comfort for patients and lowers certain risks of liposuction surgery.
Recovery
As cosmetic surgery goes, liposuction has a relatively easy recovery period. Most patients are able to return to work somewhere between 2 days and two weeks. A compression garment is usually worn for two to four weeks. Pain is controlled by a prescription or over the counter medication and may persist for as long as two weeks, depending on the procedure used. Swelling will take anywhere from two weeks to several months to fully dissipate. Numbness may persist for anywhere from several days to several weeks, again, depending upon the procedure. In general, normal activity can be resumed within a week, though in some cases it takes several weeks. Final results are usually evident within a month though in some cases it can take up to a full six months to really be able to see them.
Risks
Outside of the temporary and relatively minor side effects associated with liposuction (numbness, bruising, swelling, soreness) there are some risks you need to be aware of.
- Allergic reaction to anesthesia or medications
- Infection
- Damage to the skin-not a common occurrence, particularly with experienced surgeons.
- Damage tissue beneath the skin
- Skin necrosis (dead skin) - a rare complication, necrosis is when the skin dies from lack of proper circulation.
- Puncture of an internal organ – an extremely rare but very serious complication of surgery. The surgeon can puncture an organ or vital part of the abdomen if they are not careful. In cases where a puncture goes undiagnosed for too long, the patient can develop a serious infection and die.
- Contour irregularities- when too much fat is removed at one time or there is poor skin elasticity, there may be unusual indentations on the body’s contour.
- Thromboembolism – As far as surgeries go, lipo carries a low risk for blood clots but it can happen.
- Burns- Friction burns have occurred during liposuction. Make sure your surgeon is well experienced.
- Lidocaine toxicity- during tumescent liposuction, if too much saline solution with lidocaine is injected into the body or if the lidocaine concentration with the saline solution was mixed to high, a condition called lidocaine toxicity or poisoning may develop. Lidocaine poisoning at first causes tingling and numbness and eventually seizures, followed by unconsciousness and respiratory or cardiac arrest.
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