Liposuction, or the removal of fat deposits from specific areas of the body, is today the most popular cosmetic surgery procedure in America. Liposuction can help sculpt the body by permanently removing unwanted fat from specific areas that seem to be immune to the effects of diet and exercise.
Although it can never be a substitute for exercise and dieting, liposuction can remove stubborn areas that just don’t respond to more traditional methods. Liposuction should be viewed as a contouring tool and not a weight reduction tool. It works best on people of relatively normal weight with firm, elastic skin who are bothered by pockets of fat in certain areas.
Although age is not a limiting factor, older patients with diminished skin elasticity may need other procedures done that also remove excess skin. For those who seek a smoother, better proportioned body, liposuction may be the answer. The results can not only be dramatic, but if combined with a regimen of diet and exercise, permanent.
Liposuction techniques have seen significant improvements and refinements over the past 10 years. The addition of ultrasound-assisted lipectomy (UAL), tumescent fluid techniques as well as refinements in instrumentation, surgeon training and experience have all led to more precise and predictable results with shorter recovery times. Liposuction is a safe, well-proven modality if performed by licensed, board-certified plastic surgeons. Because there are many different kinds of doctors performing liposuction, it is imperative that patients take the time and effort in selecting their surgeon. For more information on choosing your surgeon, refer to the CHOSING A PLASTIC SURGEON section of this website.
Liposuction, also known as suction-assisted lipectomy (SAL), is an inherently simple conceptual technique. Prior to surgery, the areas to be suctioned are carefully marked by your surgeon using a topographical technique to guide him through the surgery. These preoperative markings are done in a standing position because once on the operating table, the areas in question become distorted. Through carefully placed inconspicuous ¼ inch incisions, the surgeon then infiltrates the fatty tissues with specially prepared solution that combines an anesthetic agent such as lidocaine with a vasoconstricting agent such as epinephrine. This solution aids in postoperative pain control as well as minimizing blood loss and bruising by constricting the tiny blood vessels present in the fat. “Tumescent”, “Wet”, and “Super-wet” are terms used to define precisely how much of this solution is infused in proportion to the actual amount of fat that is removed. Keep in mind that most of this fluid is removed during the suctioning procedure, with the small remainder absorbed by the body and excreted in the urine the first 24-48 hours after surgery.
Once the solution is infused, the surgeon then uses various sized and shaped hollow tubes or cannulas that are connected by flexible tubing to a suction pump. By moving this cannula back and forth through the fat, the fat is broken up and suctioned out. Traditional SAL is thereby a very mechanical process of breaking up the fat and suctioning it out with the same cannula. Ultrasound-assisted lipectomy (UAL) also referred to as ultrasonic liposuction uses a special cannula that vibrates at ultrasonic frequency at its tip. With this method, the ultrasonic energy breaks down the fat cells, liquifying the fat. Consequently, there is less bruising, less blood loss and the procedure is much less physically demanding on the surgeon. As an added benefit, the ultrasonic energy also creates heat at the tip of the cannula and aids in shrinking the overlying skin, making it firmer and tighter. This technology is not without risks however. It is imperative that you seek out a trained surgeon who has completed the certification process allowing him to use this type of device. Dr. Hainer is fully certified by the Plastic Surgery Educational Foundation (PSEF) in the use of ultrasonic liposuction. For more information about ultrasonic liposuction using the Lysonix Ultrasculpt device, refer to the LINKS section of this website.
CANDIDATES FOR LIPOSUCTION
The best candidates for liposuction are those who are near their ideal body weight but have fat deposits that are resistant to diet and exercise. A stable weight for 6 months is also preferred.
NOT FOR OBESITY
Liposuction is not a treatment for obesity or a weight-loss method. Undoubtedly, if you seek liposuction for weight control, you will likely find a doctor who is willing to perform the procedure. You are unlikely to have a pleasing or lasting result, however.
Cellulite is a common, unattractive “cottage-cheese” dimpling of the skin. It is a uniquely female problem that is neither weight-related nor improved by liposuction. In fact, there is no consistently reproducible, permanent method of cellulite reduction.
Liposuction can be performed using local anesthesia only, intravenous sedation or general anesthesia. The type of anesthesia will be determined by how many areas are being suctioned as well as the desires of the patient and surgeon
LENGTH OF PROCEDURE
Depends entirely on the number of areas and amount of liposuction planned, typically 2-6hrs.
RECUPERATION AND HEALING
Liposuction surgery is usually performed on an outpatient basis whether done at a hospital, outpatient surgery center, or office-based surgical suite. The small skin incisions heal quickly and are closed with one or two small absorbable sutures. Initial discomfort is minimal and well controlled with pain pills. You are given intravenous antibiotics during the surgery and are given 7-10 days of oral antibiotics after the procedure. We recommend 2-3 days off from work for most patients but this varies depending on the extent of liposuction, other medical issues, age, and type of work performed.
- Stop taking aspirin and aspirin-containing products at least one week before surgery. A sheet of medications to avoid those that contain aspirin will be provided to you.
- If you develop a cold or illness prior to surgery, please notify us so that we may reschedule your procedure. Remember, this is elective surgery so everything should be optimized to prevent potential complications.
- Vitamins are important in healing. Take a multivitamin with iron as well as vitamin C.
- All other vitamin supplements and herbal medications should be stopped, since many can actually worsen bruising.
- Smokers are encouraged to stop but this is not mandatory for liposuction surgery.
- Make certain arrangements have been made to have someone pick you up after surgery and to stay with you for the first 24 hours if possible. Transportation services are available through our office.
- Fill all your prescriptions before the day of surgery. Bring your pain pills with you the day of surgery. You may be asked to take them after your procedure before you go home.
- You may want to purchase a stool softener such as Colace, as pain medication may cause constipation.
- You will be carefully measured and fitted for a custom post-surgical compression garment. This garment will be an integral part of your recovery process and must be worn at all times for the first two weeks after surgery.
EVENING BEFORE SURGERY
- Eat lightly; avoid heavy, spicy, or gassy foods.
- Get a good night’s rest.
- Do not eat or drink anything after midnight prior to surgery. If your surgery is in the afternoon, do not eat or drink anything at least 8 hours prior to surgery. You may take any prescription medications with a sip of water only.
HOME AFTER SURGERY
- After any surgery, it is important to rest. While at rest, exercise your legs and feet to increase circulation to your legs.
- A small amount of bloody drainage through the bandage can occur.
- Do what’s comfortable, and avoid activities that cause pain.
- Begin taking liquids slowly after surgery and advance your diet as tolerated. It is best to take your medications with food rather than on an empty stomach. Call Dr. Hainer if you have any problems with nausea after surgery. He will call in a prescription for an anti-emetic.
- Any discomfort should be relieved by the pain medication.
- Mild to moderate amounts of blood–tinged drainage may occur from the incisions. This is normal and represents some of the fluid infused during the liposuction that is not reabsorbed by the body and drains out instead.
- You may wash your garment if it becomes wet or soiled.
- You may shower the day after surgery but no tub bathing for one week.
DEDICATED TO YOUR CARE
The entire surgical process begins well before your actual surgery date. Detailed descriptions of the entire pre and post-surgical course will be explained. Surgical consents will be signed once any and all questions are addressed. Drain teaching, if necessary, is provided. All prescriptions are provided and explained. If specialized garments are needed, exact measurements are made and sample garments are fitted.
During this entire surgical experience, Dr. Hainer and the entire staff at North Oakland Plastic Surgery are committed toward availability. Dr. Hainer will provide each patient with his personal beeper number that is available 24hrs a day. Your well-being and smooth recovery is of utmost importance to us all. We strive to meet all of your needs and make ourselves available at all times for any questions that may arise. Our goal through the entire process is to inform and educate you so that there are no surprises and that all your expectations are fulfilled. Care is individualized and personalized to make this entire experience a pleasant one.
THE RECOVERY PROCESS
You will typically be seen in the office 7-10 days after your liposuction surgery. It is crucial that you wear the specially designed garment to help in contouring the tissues and in aiding the shrinkage of the skin. The initial garment is to be worn 2 weeks, day and night. After the initial two-week period, another garment can be transitioned into and worn during the daytime. This second stage garment is less supportive and should be worn an additional 4 weeks.
Most postoperative bruising will resolve in 10-14 days. Most patients see a noticeable difference immediately after surgery but swelling can take 3-6 months to completely resolve. Actual weight loss will not be seen initially due to fluid retention and swelling. Pain tends to be minimal after surgery so most patients can return to work within a few days. Light activities can be resumed in one week and more strenuous exercise can resume in 2-3 weeks as long as a supportive lycra or spandex-type garment is worn. The small incisions heal imperceptibly within 2-3 weeks. Postoperatively the skin may feel numb with resolution in 2-4 weeks. The deeper tissues tend to feel hard and firm during the healing phase. Recommendations will be made in the use of portable electric or handheld battery-powered massagers to help soften and shape the tissues. This massage protocol is typically started once the bruising and any discomfort have resolved.
By 6 weeks, the tissues are softer, the garments can be discontinued and all activities can be resumed. Keep in mind that the final result will not be realized until 6 months as the tissues continue to reshape and soften and the skin continues to shrink and tighten.
- Bruising and swelling are expected. This will disappear in time. Be patient. It takes 6 weeks for the skin and soft tissues to begin to regain their natural appearance, softness, and shape.
- Small areas of numbness are not uncommon and may last 6-12 weeks. Permanent numbness is extremely rare.
- Sensations of sharpness and burning can occur during the healing process.
- You may drive as soon as you are comfortable enough to stop in an emergency.
- It is not uncommon to begin your menstrual cycle early due to the stress of surgery.
- In some patients, antibiotic use may lead to a vaginal yeast infection, which is easily treated with an over-the-counter anti-fungal preparation or Dr. Hainer will prescribe something for you.