·        The Ideal Candidates

·        Areas Treated with Liposuction

·        Age Limitations

·        Person Not Suitable for Liposuction

·        Changes After Liposuction

·        Complications

·        Liposuction Techniques

·        Power Assisted Liposuction

What is Liposuction

Many persons can accumulate extra fat that is resistant to exercise and diet. If diet & exercise cannot remove this resistant fat on your hips or belly, you may be able to get rid of that localized area of fat through cosmetic surgery – body contouring surgery.

Liposuction is a cosmetic surgical procedure that vaccums out fat from beneath the skin to reduce fullness in specific areas. Although liposuction can produce permanent changes in body contour. It is a sculpting technique that can improve body proportions, and help to make clothing fit better.

Liposuction recontours the body by removing some number of fat cells. The number of fat cells n an adult is said to be constant. When weight is gained, those fat cells simply grow in size. How many and where fat cells are distributed is determined by factors like genes, and some people tend to have more fat cells in some body areas than others. If an area such as the lower abdomen, flanks, hips, buttocks or thighs have excess numbers of fat cells as compared to the rest of the body, these areas will always be out of proportion. Liposuction permanently removes such cells. While this is not a protection against generalized weight gain, the area that has been suctioned will remain proportionately smaller forever. Liposuction surgery is also effective treatment for enlarged female breasts and male breast ( Gynecomastia ). Removal of fat is considered permanent, however, if you gain weight the fat will go to another location. Fat possibly can return in the same area that was liposuctioned but not to the same extent. It is important to keep in mind that liposuction has limitations. It will only remove fat under the skin. It will not remove fat that is inside the abdomen or under muscle. Liposuction will not change bone structure either. Therefore, your results may be limited to your own body structure.

Megaliposuction is removing large amount of fat for treatment of obesity, to reduce weight.

The Ideal Candidates

Liposuction is most effective for removing localized fat deposits that do not respond to diet or exercise. liposuction is a contouring procedure. The best candidates for liposuthon are normal weight people with an elastic skin, reasonable muscle tone who have pockets of  fat in  certain areas. Person should be physically healthy, psychologically stable and realistic in his or her expectations.

Liposuction will not tighten muscle or skin. In cases where there is a significant loss of tone and elasticity, the desired cosmetic results may require a combination of both liposuction and surgical skin & muscle tightening (like abdominoplasty, tummy tuck, thigh lift, etc.) to remove the excessive loose tissue.

Areas Treated with Liposuction

 Lower abdomen, Upper abdomen, Love handles, Hips, Inner knees, Back of the arms (the part that hangs down), Male Breast (Gynecomastia), Back rolls (thoracic rolls), Outer 2/3 of the buttock, Inner thighs, Outer thighs, Saddlebags, Neck (beneath the chin), Jowls, Breast reduction.

Age Limitations

Patients should be fully grown (post-pubescent). There is no upper age limitation, although the younger one is the better. This is particularly important in areas where there may be loose skin--particularly the abdomen. In areas where there will be loose skin, patients over 50 years of age are at increased risk for loose hanging skin and skin irregularities (dimpling or rippling of. the skin). Additionally, stretch marts in the treated areas indicate patients who are at increased risk for skin irregularities or loose skin after liposuction.

Person Not Suitable for Liposuction

Liposuction is a surgical procedure. Therefore, one must be in good overall health. Person who is on a anticoagulants, blood thinner, non-steroidal anti-inflammatory cannot be treated unless these medications can be discontinued both before and after surgery.

Lidocaine is used for tumescent anesthesia. Anyone who is allergic to Lidocaine, cannot be treated using tumescent liposuction.

One should not be pregnant nor lactating (breastfeeding).

Persons with bleeding tendencies should not be treated using liposuction unless normalisation is gained.

Persons who ara unable or unwilling to follow pre-operative and post- operative instructions should not be treated.

One should have reasonable expectations and fully understand the risks and the limitations of the liposuction procedure,. Persons with unreasonable expectations should not be treated.

Skin infection, Cold,  Viral diseases must be cured before surgery.

Liposuction is generally not used for elimination of Cellulite & Stretch marks. Since cellulite appears to be a skin dimpling and skin contour problem, removal of fat will not improve skin quality.

Changes After Surgery

 Liposuction selectively removes unwanted fat cells. Once these fat cells are removed, generally they do not grow back. Therefore, the results ate permanent, although take over 6 months to be fully seen.

New weight gained after liposuction Since liposuction permanently removes fat from a specific location, weight gain will shift to another target area. The new target area of weight gain may be desirable or undesirable. Therefore, maintaining or loosing weight after liposuction is essential. It is important to know that weight loss/gain is a factor, but changes in percent body fat are also important. Liposuction should compliment a proper diet and exercise.

Skin changes – other changes

Since liposuction will not tighten skin or develop muscle, the result will depend on the skin elasticity to regain its usual shape. For patients with loss of skin elasticity due to fluctuations in weight, sun damage, and pregnancies, liposuction may not be an option. Other techniques, such as Abdorninopiasty and Lifts may be better options.

Most patients will notice an improved body contour and loss of inches rather than kgs. Patients can expect an improvement in body shape, and will probably fit in their current dress size more comfortably or even drop one size or two.

As would be expected, liposuction does not improve the cardiovascular status of the patient.

Exercise and diet is recommended.

Amount of fat to remove

Fat removal is limited to 3000 to 5,000 cc per operation for safety reasons. If additional fat removal is needed, subsequent surgeries may be necessary.

Complications

All surgeries carry some unwanted uncertainties and risks. Liposuction is normally safe. However, it’s important to keep in mind that there are no guarantees having a good result. Though they are rare, complications can and do occur.

Factors that increase the risk from liposuction include:

-poor patient health, individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation

- who have recently had surgery near the area to be contoured.

- excessive fat removal

- performing multiple procedures along with liposuction in a single surgical session, especially under general anesthesia.

Serious but rare complications- Pulmonary embolism, blood clot, Perforation of organs, Anaesthetic complication, Lidocaine toxicity, Fluid imbalance.

Bleeding, Bruises, Seromas, Infection, Pigmentation, Lumps, Scars, Nerve injuries, Seroma, etc. are less common.

More common complications that usually require additional liposuction surgery include irregularities in contour and asymmetry.

Removing more than 5 liters of fat in a single liposudion treatment is considered too risky by most surgeons.

Liposuction Techniques

Liposuction is a procedure in which localised deposits of fat ate removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed through the fat layer, breaking up the fat cells and suctioning them out. If many sites are being treated,. your surgeon will then move on to the next area, working to keep the incisions as inconspicuous as possible.

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, if you believe you want liposuction in the abdominal area, you may learn that an abdominoplasty or “tummy tuck” may more effectively meet your goals. 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. -

Anesthesia

Various types of anesthesia can be used for liposuction procedures. Liposuction can be performed under local anesthesia. However, if you prefer, the local is usually used along with intravenous sedation to keep you more relaxed during the procedure.

Regional anesthesia can be a good choice for more extensive procedures. like epidural or spinal. However, some patients require general anesthesia, particularly if a large volume of fat is being removed.

The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used.

Preparing for your surgery - preop

Your surgeon will give guidelines on eating and drinking, smoking, and taking or avoiding certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed.

Power Assisted Liposuction

At KRISHNA HOSPITAL we use the MicroAire Power Assisted Lipoplasty (PAL) Device to perform this procedure. It uses powerised cannula at 2 mm reciprocating movement at 4000 cycles per minute to facilitate the procedure. This means that less force is required, especially in areas with more fibrous tissue. That makes the lipoplasty procedure easier on patients. The PAL is not ultrasonic. No heat is generated by the instrument or cannula, so burning isn’t a concern.

Patient Benefits: Less Trauma, Better Results, No Heat means No Risk of Burning.

PAL requires less effort because a powered tube allows the fat to be sucked up easier by pushing through the tissue. PAL reduces force needed, especially  in areas with more fibrous tissue such as the chest, back, breast. It facilitates fat removal in the love-handle” area in men and enlarged breasts (gynecomastla) also in men. The electric powered tube is more efficient, so the patient spends less time in the operating room.

The MicroAire Power Assisted Lipoplasty Device makes it easier on everyone.

 Power-assisted liposuction allows for the body fat to be removed in a significantly safer, faster and less traumatic way than could ever be achieved manually by pumping a cannula back and forth. Power-assisted liposuction has been shown to successfully remove unwanted fat in all areas of the body more efficiently with a faster healing time than traditional liposuction.

Post-operative

The local anesthesia injected into the tissue remains for about 24 hours following liposuction surgery, greatly minimizing post-operative pain.

After PAL, most patients are generally alert. Patients are encouraged to walk immediately after surgery to enhance the healing process. Patients can usually return to a desk-type job within a few days. Physical exercise may be resumed three to seven days after the procedure.

After surgery, you will likely experience some fluid drainage from the incisions.

To control swelling and to help your skin better fit its new shape  pressure elastic garments are needed for 8 weeks. Your doctor may also prescribe antibiotics to prevent infection.

Don’t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. 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 anxious or depressed in the days or weeks following surgery. However, this feeling will subside as you begin to look and feel better.

Back to normal

The stitches if any are removed or dissolve on their own within the first week to 10 days.

Activity that is more strenuous should be avoided for about a month as your body continues to heal. Although most of the bruising and swelling usually disappears within three 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.

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, call your doctor.

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 four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.

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.

As healing progresses, a more proportional look will emerge.

A slimmer body contour can help you feel more confident and comfortable.