Liposuction

What is liposuction?

Liposuction or suction lipectomy is one of the commonest cosmetic procedures worldwide. It is a safe and effective means of body contouring and gives predictable results. It produces definite inch loss in the treated area by local removal of fat cells.

This article will give you a basic understanding of the procedure but will not answer all your questions. Do ask your doctor about the details.

How does it work?

Liposuction involves the removal of extra fat cells from the subcutaneous layer by the use of blunt cannulas connected to suction machine. The natural elasticity of the skin then helps to redrape it to the reduced contour. The net result is a more pleasing contour of the treated part.

Indications – who can benefit from the procedure?

The best candidates are people who are normal weight or marginally overweight with firm and elastic skin who only have pockets of excess fat in certain areas. Indeed, most of these patients have tried traditional weight loss methods which have worked partially and they are now left with certain areas of stubborn fat which they wish to be removed.

The patient should also be physically healthy, psychologically stable and realistic in expectations. Age is not a major consideration but older patients with decreased skin elasticity may not achieve the same result as younger patients with tight skin.

Who cannot benefit from liposuction?

It is not a procedure for generalized obesity which is best treated by diet, exercise, behavioral treatment and sometimes drugs. Removal of excessive fat in a single sitting from a single location can produce loose wrinkled skin which will not redrape and require skin removal as a secondary procedure. Besides there can be serious risks associated with the removal of too much fat in a single sitting leading to serious and even fatal complications. Currently removal of up to 5 liters of fat is considered safe. Larger amounts can be removed [ called mega volume liposuction] but his is not without risk. Those who resort to liposuction to lose weight will be disappointed.

Anesthesia

The procedure can be done under general, regional or local anesthesia. Tumescent technique lends itself to liposuction under local anesthesia complimented with some sedation.

Procedure

The procedure begins with marking the outline of the affected areas. Areas with too much fat are identified as are areas which have to be avoided. Tumescent mixture is injected in the area to be treated-this helps to reduce blood loss and make the procedure less traumatic.

After a brief period of waiting, small cannulas [hollow metal pipes] are introduced through small incisions placed in strategic locations and connected to a high pressure suction machine. Forward and backward movements of the cannula suck the fat out of into a suction bottle. After the end point is reached, as determined by the pinch test, the areas are dressed with elastic adhesive [Dynaplast].

The tapes are removed by the patient in a shower after one week. After that the patient wears elastic wraps to support the skin and soft tissues in the healing process for a period of 6 weeks to 3 months. This helps in the skin falling back and redraping over the reduced contour. The garments can be custom fitted garments or regular off the shelf cycling shorts.

Complications

Medical– Hematomas, Seromas, infection including necrotizing fasciitis, fat embolism, shock

Aesthetic– Contour problems, lax skin

Variations

Liposuction can be done with the help of large sized syringes. [Syringe liposuction]It can be done using power cannulas which reciprocate hand movements to avoid fatigue.

Ultrasonic liposuction uses pulses to lyse the fat followed by traditional liposuction [VASER]. It is useful in areas where fat is tough e.g. chest area in males.

Terminology

  • SAL suction assisted liposuction
  • PAL Power assisted Liposuction; a power device moves the cannula back and forth to reduce operator fatigue
  • UAL Ultra sound assisted liposuction-VASER
  • LAL Laser assisted liposuction; a laser device loosens the fat globules before they are sucked out.

Problem areas that can be addressed with liposuction:

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