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If you are considering liposuction in Southern California including Beverly Hills, Santa Monica and Long Beach from a Board Certified Female Plastic Surgeon continue reading ...

What is liposuction? Suction Assisted Lipectomy (SAL) or liposuction is a surgical technique in which the removal of fat deposits reshapes a specific part of the body, such as the face, neck, arms, abdomen, hips or thighs. Liposuction, which was actively practiced in Europe during the mid 1970's, was not popularized in the United States until the early 1980's. Since then it has become the most requested aesthetic surgical procedure. The popularity of this operation is based on its relative simplicity which requires only a small incision usually well-hidden in a normal skin fold.

Frequently, patients seek liposuction to reduce their weight and general obesity. Unfortunately, liposuction is not indicated to treat these problems. Standard methods of weight reduction are required for these patients. Liposuction is intended to resculpt isolated collections of body fat that would not generally respond to diet and exercise: it is a method of body contouring to reduce inches, not pounds. The good news is that the suctioned fat cells are permanently removed. If the patient gains weight later on, the new fat will be distributed in a more proportioned manner.

Who should have liposuction? Patients with average weight, localized fat collections, and healthy elastic skin are the best candidates for liposuction. Obesity, cellulite, or loose, sagging, inelastic skin are several problems that would tend toward poor results. In fact, these problems may be worsened by liposuction. Unfortunately, many individuals performing liposuction are not trained in other techniques of body contouring and may not have the experience to recognize that a different procedure (such as a tummy tuck) may provide a better result for the patient. SAL may be used in conjunction with other body contouring procedures, such as breast reduction, tummy tuck, thigh lift or face lift.

How is the operation performed? Liposuction can be performed in an outpatient setting such as the surgeon's office or surgicenter; less frequently a short hospitalization will be required. The procedure can last from 30 minutes to several hours depending on how many body areas are being operated upon. The type of anesthesia will also vary. Local anesthetic with sedation can be used for small areas; however, more extensive procedures usually require general anesthesia. Through a small incision, usually less than one-half inch, a blunt-tipped instrument called a cannula is passed back and forth essentially vacuuming out the fat. The cannula is connected to rubber tubing which in turn attaches to a machine that generates high vacuum pressure. Following surgery, a firm elasticized garment is used to provide compression and reduce swelling and discoloration at the surgical site.

During larger volume surgery, IV fluids are given to replace losses that occur with the procedure. Very rarely, transfusion is required, but this can usually be anticipated prior to surgery so that the patient can receive his/her own blood (aurologous donation).

What can I expect after the operation? As in all operations, pain and discomfort varies greatly from patient to patient. Generally, pain medication would be required for the first several days. Continuing discomfort can last varying amounts of time. Much of the swelling and bruising will be improved by two weeks; however, some will persist for six to eight weeks. It is often difficult to see significant changes in the body shape before this time. It is frequently useful to wear an elastic garment for four to six weeks to help with skin shrinkage. Your doctor will tell you how long you should wear your elastic garment. Normal activity may be resumed at one to two weeks and exercise at two to four weeks. Your doctor will give you specific time periods during a post-operative visit. Persistent swelling and irregularities may be present for several months. If antibiotics are prescribed, they should be taken as directed.

Is hospitalization necessary? Usually hospitalization is not necessary but it depends on the volume of liposuction and any other additional surgery. Many of these operations are performed under general anesthesia and may be done at a surgicenter as outpatient surgery.

Is there an age limit for this operation? People under 40 years of age usually get the very best results because their skin is tighter. However, the state of the skin remains the determining factor, regardless of age.

Are bandages applied? As discussed earlier, compression garments are worn after the operation to assist in the retraction of the skin and to prevent swelling. Light massage is started on the 10th day. After the operation, exercises are recommended beginning on the 14th day in order to minimize the adhesions between the skin and the deeper tissues. Early results are seen 10-14 days after surgery but improvement continues for 4-6 months.

When can you return to work? In general, 3-5 days after the operation for office work, and 14 days for more active employment. This will depend on the amount of liposuction and the type of work.

When can you do exercises? Usually 2 weeks after the operation you may exercise in order to modify and diminish the adhesions between the skin and the tissue. Walking, swimming or a stationary bicycle can usually begin a few days after surgery.

Should you follow a special diet? In order to have the best results, it is good to have a well-balanced diet including carbohydrates, fruits, vegetables and proteins, and not to overeat salty or fatty foods.

When can you get out in the sun again? When all the bruises have disappeared. this takes about 2-3 weeks. Use a sunscreen with a SPF of at least 15. Decreased sensation in the first few months after surgery may result in an accidental sunburn. Be careful.

Are the results permanent? In general, yes. In you gain weight, however, the operated area will also increase but not as much as would have occurred before the operation. Rippling may also occur with large weight gain.

Can the operation be repeated? Yes in certain cases. It is preferable to operate in stages on heavier people.

What about scars? Following surgery, your surgical scars will go through a maturation process. For the first few months, they will be red and possible raised, firm or unsightly. As the scar matures, after 6-12 months, it becomes soft, pale, and flat and much less noticeable. You may experience numbness, tingling, burning, "crawling" or other peculiar sensations around the surgical area. This is a result of the healing of tiny fibers which are trapped in the scar. These symptoms will disappear. Some people are prone to keloids which is an abnormal scar that becomes prominent and unsightly with time. If you or a blood relative have a tendency to keloid formation, please inform the surgeon.

What happens to the excess skin? Depending upon the age of the patient, the skin (because of its elasticity and retraction), will shrink over the reduced area of the body. Older or excess skin may require subsequent surgery to obtain the desired result.

Why is it important to have pre-operative pictures taken? Pictures help in the analysis of the problem in pre-operative planing, as a guide during surgery and in evaluation results. Consequently, they are necessary prior to all plastic surgery procedures.

What are the potential risks and complications?

Initial

1. General risks of surgery can include infection, delayed wound healing, seoma (a fluid collection below the skin), hematoma (a collection of blood below the skin), bleeding reactions to anesthetic. (See list of medications that may increase bleeding)

2. Fluid collections – blood , serum – usually temporary without consequences though it can lead to deformity.

3. Waviness and asymmetries (cellulite does not improve). Liposuction is not an exact technique and our bodies are not perfectly symmetric.

4. Tape reactions or burns, blister formation.

5. Pain or sensory changes i.e. burning sensation , decreased or lost sensation (numbness) or hypersensitivity. especially with areas that were done with ultrasonic liposuction or repeat areas of liposuction.

6. Prolonged swelling (edema).

7. Infection can occur rarely, but antibiotics are given at surgery and post-operatively.

8. Skin breakdown. If severe blistering and swelling occur, the overlying skin can result in an open wound.

9. Skin pigment changes

10. Shock. This extremely rare occurrence usually happens with extreme fluid losses or #11.

11. Fat embolism. Microscopic fat particles enter the blood circulation and travel to lungs and other organs.

12. Death - (very uncommon) Usually from inadequate monitoring with extreme body fluid shifts.

13. General risks of anesthesia.

14. Numbness or contour irregularities can be long lasting or even permanent and may require revisional surgery.

15. Additional Surgery: Any of the problems or disorders noted above may require additional surgery. If this occurs there will be additional costs for surgical fees, supplies, anesthesia, etc. depending upon the required operation.

16. ANY FUTURE REVISIONAL SURGERY WILL INCUR ADDITIONAL COSTS TO BE PAID BY THE PATIENT.


VIEW LIPOSUCTION PHOTOS