Suction-assisted lipectomy - also known as liposuction, fat suction, or suction lipectomy - is a technique to remove unwanted fat deposits from specific areas of the body, including the chin, neck, and cheeks; the upper arms and above the breasts; the abdomen, buttocks, hips, and thighs; and the knees, calves, and ankles. Liposuction is not a substitute for weight reduction, but a method of removing localized fat that doesn't respond to dieting and exercise. If you're considering liposuction, this will give you a basic understanding of the procedure - when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your doctor about anything you don't understand.
The best candidates for liposuction Liposuction can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon. The best candidates for liposuction are of relatively normal weight but have pockets of excess fat in particular areas. You should be physically healthy, psychologically stable, and realistic in your expectations. Most important, having firm, elastic skin will result in a better final contour. (Hanging skin won't reshape to your body's new contours, and may require an additional procedure to surgically remove the excess skin. This procedure will leave visible scars.) Suction lipectomy is not recommended if you've had recent surgery on the spot to be sculpted, if you have poor blood circulation in that area, or if you have heart or lung disease. You should also understand that liposuction by itself will not improve the dimpled skin known as cellulite, though some plastic surgeons offer other techniques that may improve this condition.
All surgery carries some uncertainty and risk
Suction-assisted lipectomy is normally safe, as long as patients are carefully selected, the operating facility is properly equipped, and the physician is adequately trained in body contouring as well as general surgery. Nevertheless, in rare instances, the procedure may cause severe trauma, particularly when multiple or very extensive areas are suctioned at one time. Other infrequent, but possible, complications include fluid accumulation (which must be drained) and injury to the skin. Although serious complications are infrequent, infection or excessive fluid loss can lead to severe illness. You can reduce your risks by choosing a qualified plastic surgeon who has been granted privileges to perform liposuction at an accredited hospital, and by closely following his or her advice. The scars from liposuction are small and strategically placed to be hidden from view, even in a bikini. However, other cosmetic problems may occur, even if your surgeon is very skilled. They may include rippling or bagginess of the skin over the treated area, and pigmentation changes (such as brown spots) that may become permanent if exposed to the sun. Asymmetry (uneven contour or shape) sometimes requires a second procedure.
Planning your surgery In your initial consultation, the surgeon will evaluate your health, determine where your fat deposits lie, and carefully assess your skin tone. Your doctor should explain any alternative body-contouring methods that may be appropriate - such as abdominoplasty, or tummy tuck - and discuss the options or the combination of procedures that would be best for you. Be frank in discussing your expectations with your surgeon. He or she should be equally frank with you, describing the procedure in detail and explaining its risks and limitations. Your surgeon should also explain the anesthesia he or she will use, the type of facility where the surgery will be performed, and the costs involved. During this consultation, be sure to tell your surgeon about any large weight losses or gains you've had at any time. You should also inform your surgeon if you smoke, and if you're taking any medications, vitamins, or other drugs. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing for your surgery
If you're having extensive liposuction, discuss the possibility of having blood drawn ahead of time with your doctor. Your own blood can be used to help replace the blood and other fluids you'll lose during surgery if your doctor feels this is necessary. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets, and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your procedure will have to be postponed. While you're making preparations, be sure to arrange for someone to drive you home after your surgery and, if needed, to help you out for a day or two.
Where your surgery will be performed Suction-assisted lipectomy may be performed in a surgeon's office-based facility, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, for cost containment and convenience. Extensive procedures may require a hospital stay of two or three days.
Types of anesthesia If your procedure is not too extensive - that is, the amount of fat and fluid removed does not exceed an amount your doctor will define based on your health, body size, and surgical procedure - liposuction can be performed under local anesthesia, which numbs the area, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort. Some surgeons may instead use an epidural block, similar to the anesthesia used in childbirth. If your doctor plans to suction a large area, or to treat several sites, you'll probably have general anesthesia. In that case, you'll sleep through the operation.
The Surgery
Suction-assisted lipectomy usually takes an hour or two, but the time required may vary considerably - from thirty minutes to several hours, depending on the area and amount being suctioned. To begin the procedure, the surgeon makes a small incision, just large enough to allow the insertion of a hollow tube called a cannula. The opposite end of the cannula is attached to a machine that creates a strong vacuum. The surgeon manipulates the cannula deep within the fat layers under the skin, breaking up the fat and suctioning it out. Sometimes additional incisions are needed to remove all areas of fat. If you've had local anesthesia, you'll feel some vibration and friction during the procedure. You may also feel a stinging sensation as the cannula moves closer to the muscle. You'll lose fluid along with the fat during liposuction, and it's crucial that this fluid be replaced to keep your body from going into shock. You'll be given fluids intravenously, and if needed you may also receive a blood transfusion (usually the blood you've donated in advance).
After your surgery After surgery, a drainage tube may be inserted beneath your skin for one to three days to remove any fluid build up that occurs. A snug elastic dressing, girdle, or body stocking must be worn over the treated area to control swelling and bleeding, and to help your skin shrink to fit your new contour. You may need to wear this garment continuously for two to three weeks, then just in the day time for a few weeks more, depending on your surgeon's instructions. Your doctor may also prescribe antibiotics to prevent infection. Don't expect to look or feel great right after surgery. You'll even be heavier for a while, because of the extra fluids you've been given. The suctioned areas will be swollen and bruised, and you may feel a burning sensation. The pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days. You may temporarily lose all feeling in the suctioned area; don't worry - it will return. It's not unusual to feel depressed in the days or weeks following surgery. Try to keep in mind that this is normal and will subside as you begin to look and feel better.
Getting back to normal
Healing is a gradual process. Your surgeon will probably tell you to start walking around as soon as possible (to help prevent blood clots from forming in your legs), but to avoid more strenuous activity for two to four weeks. Any stitches will be removed in five to ten days or dissolve, and you should be back at work in 2 - 3 days, or as much as two weeks after your surgery. When you resume activity depends on the extent of your procedure, how you feel and what your doctor recommends. While most of the swelling and discoloration will be gone a month or two after surgery, some swelling can re main for six months or more. Your surgeon will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed. If you have any unusual symptoms between visits - for example, heavy bleeding or a sudden increase in pain - or any questions about what you can and can't do, don't hesitate to call your doctor.
Your new look Suction-assisted lipectomy is a highly effective technique for giving you a new body contour with very little scarring. The results can be permanent, providing you eat sensibly and exercise regularly. If you do gain weight, you'll probably gain it more uniformly throughout your body, not just in the former "bulges." Most patients are very satisfied with the results of their liposuction - they feel more comfortable in a wide variety of clothes, and more at ease with their bodies. As long as your expectations are realistic, you should be happy with your new shape.
If you're considering UAL...
Ultrasound-assisted lipoplasty, commonly known as "UAL," is a relatively new liposuction technique that uses sound waves to liquefy unwanted fat. Although it is not a substitute for traditional liposuction, UAL can be an effective tool for removing fat from fibrous body areas, such as the male breasts or the back, or for removing larger volumes of fat in a single procedure. Often, traditional liposuction is performed with UAL to help shape UAL-treated areas or to treat areas of the body not suited for UAL, such as the neck and inner thighs. If you are considering UAL, the following information will provide an overview of the technique: when it can help, how it is performed and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Ultimately, you and your plastic surgeon will determine whether UAL or traditional liposuction is best suited for you. Please ask your physician if there is anything about the procedure you don't understand.
The best candidates for UAL Liposuction can enhance your appearance and your self confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have UAL or liposuction of any type, think carefully about your expectations and discuss them with your surgeon. The best candidates for UAL are generally no different than candidates for the traditional liposuction procedure: normal-weight people with firm, elastic skin who have pockets of excess fat in particular areas. UAL candidates should be physically healthy, psychologically stable and realistic in their expectations. Age is usually not a criterion for liposuction, but older patients may have diminished skin elasticity and may not achieve the same results as a younger patient.
All surgery carries some uncertainty and risk Since it was first described in the medical literature in 1991, UAL has been performed on several thousand patients worldwide. However, long-term effects of ultrasound energy are not known and extensive research and clinical trials are needed to establish fully the safety and efficacy of UAL. So far, clinical investigators have reported good results from the technique. UAL is normally safe when patients are carefully selected, the operating facility is properly equipped and the physician has completed an appropriate, hands-on UAL training course. As with traditional liposuction, serious medical complications from UAL are infrequent. However, possible complications include clots that block blood flow, infection, excessive fluid loss that can lead to shock, excessive fluid accumulation that must be drained, skin injury, perforation injury to the skin or other organs and adverse reactions to anesthesia. One potential complication specifically related to the UAL technique is thermal skin injury or burn caused by the heat from the ultrasound device. Also, temporary collections of fluid beneath the skin surface (seromas) are more common with UAL. Also, you should be aware that at present, the tube-like instruments or cannulas used to perform UAL are slightly larger than the cannulas used for traditional liposuction. The longer incisions that are needed for UAL require that they be placed carefully in hidden areas. For this reason, some surgeons prefer to use the traditional liposuction technique in areas where an obvious scar may result. Cosmetic complications from all types of liposuction include: irregularities of the skin's surface, areas of uneven pigmentation, and asymmetry. Some cosmetic problems can be treated with additional surgery.
Planning your surgery
In your initial consultation, your surgeon will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. Your surgeon will explain the body contouring methods that may be most appropriate for you. For example, you may learn that an abdominoplasty or "tummy tuck" may more effectively meet your goals; or that a combination of traditional liposuction and UAL would be the best choice for you. Be frank in discussing your expectations with your surgeon. Also, be sure to tell your physician about any significant weight losses or gains you have had at any time. You should inform your surgeon if you smoke, and if you're taking any medications, vitamins or other drugs.
Preparing for your surgery Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your procedure may have to be postponed. While you are making preparations, be sure to arrange for someone to drive you home after your surgery and, if needed, to help you out for a day or two.
Where your surgery will be performed UAL may be performed in a surgeon's office-based facility, an outpatient surgery center, or a hospital. It is usually done on an outpatient basis. If a large volume of fat will be removed, a stay in a hospital or overnight nursing facility may be required.
Anesthesia for UAL If you are having only a small amount of fat removed, UAL may be performed under local anesthesia combined with a sedative to make you drowsy. You will be awake but relaxed and feel only minimal discomfort. Some surgeons may prefer to use an epidural block, similar to the anesthesia commonly used in childbirth. General anesthesia may be used if you prefer it, or if your doctor so advises. In that case, you will sleep through the procedure.
The surgery The time required to perform UAL may vary considerably, depending on the amount of work you are having done. However, UAL generally takes longer than traditional liposuction because of the extra "fat-liquefying" step involved. To begin the procedure, salt water containing local anesthesia and adrenaline is injected into the area to be treated. Then, a metal cannula connected to an ultrasound generator is inserted beneath the skin through a small incision. The ultrasonic energy causes the walls of the fat cells to break down, allowing the fat to flow out of each cell. The "liquified" fat combines with the injected fluid to create an emulsion, which is removed from the body by vacuum pressure. If you are awake, you may feel some warmth and vibration during the procedure. You will probably be given some fluid through an IV (intravenous) tube to keep your fluid level balanced. Typically, only a small amount of blood is lost during UAL. However, if your surgeon determines that a blood transfusion may be needed, you can donate your own blood in advance of the procedure.
After your surgery
After surgery, you will likely experience some fluid drainage from the incisions. A drainage tube may be inserted beneath the skin to prevent fluid build-up. To help control swelling, you may be fitted with a snug elastic bandage or compression garment to wear over the treated area. The bandage or garment is typically worn for up to four weeks, to help your skin shrink to fit its new contour. The side-effects of traditional liposuction surgery -- pain, burning, swelling, bleeding and temporary numbness -- can be expected from UAL as well. The pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days. It is normal to feel a bit depressed in the days or weeks following surgery. This feeling will subside as you begin to look and feel better.
Getting back to normal Healing is a gradual process. Your surgeon will probably tell you to start walking around as soon as possible. You will begin to feel better after about a week and you should be back to work within two weeks following your surgery. Any stitches are usually removed within the first week. Activity that is more strenuous should be avoided for about three weeks as your body continues to heal. Although most of the bruising and swelling usually disappears within six weeks, some swelling may remain for six months or more. Your surgeon will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed.
Your new look 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 six weeks, when most of the swelling has subsided. If your expectations are realistic, you will probably be very pleased with the results of your surgery. 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 permanently.
Abdominoplasty, known more commonly as a "tummy tuck" is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar-which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip. If you're considering abdominoplasty, the following information will give you a basic understanding of the procedure - when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.
The best candidates for abdominoplasty The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent. Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
All surgery carries some uncertainty and risk
Thousands of abdominoplasties are performed successfully each year. When done by a qualified plastic surgeon who is trained in body contouring, the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure. Postoperative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.
Planning your surgery In your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you smoke, and if you're taking any medications, vitamins, or other drugs. Be frank in discussing your expectations with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each. If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also known as a mini-tummy tuck, which can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result. In any case, your surgeon should work with you to recommend the procedure that is right for you and will come closest to producing the desired body contour. During the consultation, your surgeon should also explain the anesthesia he or she will use, the type of facility where the surgery will be performed, and the costs involved. In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure.
Preparing for your surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed. Whether your surgery is done on an outpatient or in patient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.
Where your surgery will be performed Many surgeons perform both partial and complete abdominoplasties in an outpatient surgical center or an office-based facility. Others prefer the hospital, where their patients can stay for several days.
Types of anesthesia Your doctor may select general anesthesia, so you'll sleep through the operation. Other surgeons use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and your abdominal region will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)
The surgery
Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two. Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched. Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site. In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
After your surgery
For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you may be re leased within a few hours or you may have to remain hospitalized for one to three days. Your doctor will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible. Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks. The dressing on your incision may be replaced by a support garment.
Getting back to normal
It may take you weeks or months to feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate. Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably. Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.
Your new look Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly. If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.
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