Liposuction (Suction Lipectomy)
Liposuction (suction
lipectomy) is a technique for removing body fat by using a
suction curette through a very small incision. Its advantage
is that the scar is very small. However, since the procedure
doesn’t remove skin, it may give a more limited result
because the skin is not tightened and it must shrink on its
own. The contour of the suctioned areas will always be somewhat
wavy and irregular, although in many patients, this is hard
to see. It is not useful for a generally heavy leg or thigh
without bulges, as the changes are not noticeable. Suction
lipectomy frequently is used during other procedures to “feather”
the edges – remove a slight fullness or contour a form,
for instance in facelift procedures. It is a contouring operation,
not a substitute for weight loss. It does not treat or improve
cellulite, and in fact, waviness may be worse after surgery.
Suction lipectomy can be performed on the chin, neck, cheek,
upper arms, breast, abdomen, “love handles,” buttocks,
hips, thighs, knees and calves.
The best candidates for this type of liposuction are of relatively
normal weight with firm, elastic skin, but have pockets of
excess fat in certain areas. You should be physically healthy,
psychologically stable and realistic in your expectations.
Most importantly, having firm, elastic skin will result in
a better final contour. Your age is not a major consideration;
however, older patients have less skin elasticity and may
not achieve the same results as younger patients with tighter
skin. Hanging skin will not reshape to your body’s new
contours and may require an additional procedure to remove
the skin. Surgery that removes excess skin leaves visible
scars.
The risks are blood clots, infection and irregularities in
contour. The procedure usually requires a general anesthetic
and can be done on an outpatient basis. The more areas suctioned,
the higher the risk of these complications. Skin and nerves
can suffer friction burns and injury. Vital organs can be
punctured or injured, and infections and delayed wound healing
can complicate recovery. In very unusual cases, there have
been fat clots or blood clots that migrate to the lungs and
cause death. Excessive fluid loss can lead to shock.
If you are having extensive liposuction, you can donate your
own blood before the procedure in case you need it afterward.
You must have nothing to eat or drink after midnight the night
before your surgery. You must stop smoking two weeks before
the surgery because the chemicals in cigarettes interfere
with wound healing. If you have an infection of any kind,
call your doctor. Make arrangements for someone to drive you
home after surgery and to help care for you for a day or so
after the surgery. Wear loose-fitting clothing on the day
of surgery. You must stop any type of blood thinners, aspirin
or NSAIDS (ibuprofen or Advil) for one week before the surgery.
The time required for the surgery varies, depending upon the
size of the area, the amount of fat being removed, the type
of anesthesia and the technique used. An average case takes
one to two hours, but can take as little as 30 minutes or
as much as three hours. Small incisions through the skin enable
the doctor to insert the narrow metal tube. The tube is connected
to a high suction machine to supply a strong vacuum. The tube
is then moved around under the skin, breaking up the fat and
suctioning it out.
You will loose fluid along with fat during the procedure.
It is important that this fluid be replaced to keep your body
from going into shock. For this reason, patients need to be
carefully monitored and receive intravenous fluids during
and immediately after surgery. Most patients do not need a
blood transfusion.
The scars from liposuction are small and strategically placed
to be hidden from view, even in a bikini. However, other cosmetic
problems can occur. These might include ripping or bagginess
of the skin over the treated area; pigmentation changes, such
as brown spots that may become permanent if exposed to the
sun; or asymmetry (the two sides not being the same). Everyone
is asymmetrical, and although surgeons attempt to even up
the differences, new asymmetries can occur.
Recovery takes two to four weeks. Showers may be taken after
five to seven days, but at other times, a pressure dressing
should be worn for two to three weeks. After your surgery,
a snug elastic dressing, girdle or body stocking must be worn
over the treated areas to control swelling and bleeding. This
garment also helps your skin shrink to fit your new contour.
You may need to wear this garment all the time for the first
two to three weeks and then during the day for a few weeks
more.
There also may be one or more drainage tubes inserted under
your skin for a day or two. This drain helps remove any fluid
buildup. You will be given instructions on how to manage the
drain and record the output for the doctor. You also may be
given a prescription for antibiotics.
Don’t expect to look or feel great right after surgery.
You will be heavier for a while from the extra fluids. The
suctioned areas will be swollen and bruised, and you may feel
a burning sensation. The pain can be controlled with medication,
but you will still feel sore for a few days. You may temporarily
lose all feeling in the suctioned area; don’t worry,
it usually returns.
You will have any stitches removed in a week to 10 days unless
the doctor tells you that you have dissolving stitches.
It’s not unusual to feel depressed right afterward.
Try to keep in mind that this is normal and will get better
as you get better. You will begin to feel better after about
a week or two and should be back at work in somewhere from
a few days up to two weeks after surgery.
Healing takes time. Start walking around as soon as you can
to help prevent blood clots. You should not engage in heavy
activity for a month after surgery.
Most of the swelling and discoloration will be gone about
six weeks after surgery. But some swelling can remain for
six months or more.
If you notice any suddenly increased pain, any bleeding or
suddenly increased swelling, notify the doctor immediately.
Making an Appointment
For a consultation with a
Washington University cosmetic surgeon, please call (314) 362-4452.
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Disclaimer:
The photos on this website are of models, not actual patients.
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