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Why Liposuction?
"The
last few inches"
Many people have active lifestyles including an exercise and diet
program. They are close to their ideal body weight and may be
considered quite trim. However, there are some places on their body
that refuse to relinquish the last bit of fat. This causes an
undesirable alteration to their body shape. This is due to the presence
of resistant fat that is called alpha fat. Alpha fat responds very
poorly to diet and exercise but can be removed by liposuction. These
individuals respond great to liposuction and are quite pleased with
their results!
"Pregnancy
changes" As an obstetrician for almost 3 decades, I am very
familiar with the changes in body configuration that occur after
pregnancy. I have seen the unhappy mothers whose figure was totally
changed after one or more pregnancies. Many people want to regain their
pre-pregnancy figure and can be helped greatly by liposuction. By
targeting this "baby fat", a more youthful and pleasing body image can
be obtained.
"Menopausal
changes" Everyone expects drastic changes in body shape and
size at puberty. However, many are surprised that menopause is also
accompanied by a change in your body shape. This includes a tendency for
fat to accumulate in places it never had before! This undesirable
build-up distresses many patients. Fortunately, liposuction can correct
many of these changes and help turn back the clock to a more balanced
body configuration.
"It
runs in my family" As we age, our body shape changes.
This can be due to many factors including our genes. At the next family
picnic, look around. Does your family tend to have 'saddlebags', 'spare
tires', 'batwings', 'love handles', 'turkey necks', 'pot bellies' or
other asymmetrical shapes. These are some of the primary areas targeted
by liposuction.
"My
clothes just don't fit properly anymore" Many times an
imbalance in different body areas is responsible for body asymmetry.
There might be a big difference between the upper and lower halves of
the body. Liposuction can help bring back the symmetry between these
two areas.
"I
want to feel confident again" Sometimes body image can change
so much that it affects the way we feel. You might be retired and feel
that people might be focused on your problem area when you are on the
golf course or on the water. You may be starting a new career, going
away to school or starting a new relationship. A disproportional body
area may keep you from feeling as confident as you once felt.
Liposuction can help restore the body's balance and correct these
problem areas.
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Who Benefits from Liposuction
Body contouring
not weight loss Liposuction is not a weight loss procedure. In
fact, only a small amount of weight is lost after liposuction.
Liposuction works best to re-contour the body. Think of the fellow that
plays Santa at Christmas. He stuffs a feather pillow under his suit.
Little weight is gained but a big difference in body contour results.
Fat is very light
but bulky Because of this, the best candidates for liposuction are
within 25 pounds of their ideal body weight. They often achieve
excellent results from liposuction.
Individuals up to 50
pounds above their ideal weight have significant amounts of both
external fat and internal fat (inside the abdomen). Liposuction does
not remove the internal fat. However, good results can still be
obtained from liposuction depending upon the area involved. They are
more likely to require multiple areas of body recontouring.
Individuals over 50
pounds above ideal weight obtain much more limited results with
liposuction. Neck and arm reduction procedures can still provide good
results. However, results in other areas are much less satisfactory.
In selected cases, there is still some improvement in the way clothes fit and
feel.
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Important Information about Tumescent
Liposuction
Risks of Liposuction Surgery:
Any surgery involves the risk of infection, bleeding, scarring or
serious injury, however tumescent liposuction has an amazingly good
safety record. One of the reasons that tumescent liposuction is so safe
is that neither general anesthesia nor significant IV sedation is
required. Although complications are infrequent, they could result in
hospitalization for treatment. (Such costs are not included in the
quoted liposuction fee.) Patients can minimize the risk of
complications by not taking medications or over-the-counter preparations
that might adversely affect the surgery. Patients should inform the
surgeon of any medications being taken either regularly, or
occasionally, including herbal remedies and dietary supplements.
Risk of Irregularities of the Skin:
Tumescent liposuction using microcannulas is the least likely to cause
any significant or noticeable post-surgical irregularities of the skin.
By magnifying the fatty compartment, the tumescent technique permits
more accurate removal of fat, with greater assurance that the
liposuction cannula will not inadvertently approach too near the
undersurface of the skin and thereby cause irregularities. Thus the
tumescent technique helps to minimize the risk of post-surgical
irregularities or rippling of the skin. Liposuction might improve
pre-existing irregularities of the skin such as dimpling or cellulite,
but prospective patients should not assume that there will be
significant improvement. It is unrealistic to expect perfectly smooth
skin. Patients should expect that their skin will have approximately
the same degree of dimpling and irregularities as existed before
tumescent liposuction surgery. However, it is possible that a
noticeable irregularity of skin may result. If an irregularity occurs,
it may require a corrective procedure for which there will be a fee to
cover the operating room and nursing staff expenses. Because skin tends
to lose some of its elasticity with increasing age and with cumulative
sun exposure, older patients might notice some subtle increase fine
wrinkles in areas such as the upper abdomen after liposuction.
Risk of Scarring of the Skin:
Incisions for liposuction may result in scarring. Tiny (1 to 2
millimeter) round holes in the skin, called adits, are used for
inserting the cannulas through the skin and into the fat. Typically,
when adits heal they become virtually invisible. Although you may be
able to find them upon close examination, most other people would not be
able to see them. Some patients may experience temporary
hyper-pigmentation (darkening) that usually fades after several months.
Some patients may have a genetic predisposition for persistent
discoloration at incision sites. Any one who has previously experienced
hyper-pigmentation or hypo-pigmentation (pale or light colored scars) of
the skin in the past might expect to also experience it with liposuction
adits or incisions. Certain areas of the body, such as the back or
upper flanks, may be more likely to have pigmentation changes.
Cellulite: Liposuction
of the thighs, while improving the silhouette, does not necessarily
eliminate the subtle "puckering" of the skin often called "cellulite".
Cellulite results from the pull of fibrous tissue that connects skin to
underlying muscle. While tumescent liposuction may reduce the degree of
cellulite, it is unlikely to eliminate it. Liposuction should not
worsen cellulite.
Obesity & Liposuction:
Liposuction is not an appropriate treatment for obesity. Liposuction is
not a substitute for a prudent diet, good nutrition, and regular
exercise. Obese patients may be good candidates for limited liposuction
if their goal is simply to improve the shape of certain limited areas of
the body. Obesity is associated with an increased risk of surgical
complications
Postoperative Healing:
Normal healing after tumescent liposuction involves a limited but
definite degree of soreness, swelling, bruising, itching and lumpy
firmness. A temporary mild numbness, itching or burning of the skin may
persist for 2 to 10 months. Most patients can actually see some
improvement of their silhouette within one week after surgery. However,
because of the slow resolution of post-surgical swelling, the ultimate
results following liposuction usually require 12 to 20 weeks to be
achieved.
Realistic Expectations:
Although the results of liposuction are often quite spectacular, it is
not realistic to expect perfection. It is impossible to guarantee the
precise amount of improvement that will result from liposuction.
Patients should not have unrealistic expectations. Although patients can
usually expect to achieve at least a 50% improvement, it is unreasonable
to expect 95% improvement or near perfection. For the perfectionist, or
for liposuction of a very large area, maximum improvement may require a
second procedure for which there would be an additional fee.
Patients who would be satisfied with a 50% improvement would be
reasonably good candidates for liposuction. The "50% improvement" is
intentionally a vague measure. It indicates a definite perceptible
improvement, but something short of perfection. If a 50% improvement
would make a patient happy, then it is likely that these expectations
will be met. Our patients generally achieve more than a 50%
improvement.
Longevity of Results:
The fat cells that are removed by liposuction do not grow back. If the
patient later gains or loses weight, the change tends to be distributed
proportionately over the entire body. For the best results the patient's
post-op weight should be less than the pre-op weight. Although one can
expect some changes with aging, provided that the patient does not gain
large amounts of weight, the patient's new, more pleasing silhouette is
relatively permanent.
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Liposuction Procedure
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After you have signed your surgical-consent forms, you will change
into a surgical gown. In the operating room the pre-operative
photographs will be taken and finally the areas on your body to be
treated with liposuction are marked with a felt-tip pen.
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For
safety purposes we routinely place an intravenous (IV) access in your
arm; it consists of a small plastic IV tube with a rubber stopper on
the outside through which medication can be injected if needed. A
blood pressure cuff is placed on your opposite arm, and cardiac
monitor leads are placed on your chest. Next, using the smallest
needles available, the doctor or the nurse will anesthetize the skin
at sites through which the longer needles or cannulas will be inserted
to anesthetize the subcutaneous fat. Patients usually experience a
slight pricking sensation as the skin becomes "numb".
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A
large volume of dilute tumescent anesthetic solution is carefully and
gently injected into the targeted fat. Once an area has been well
infiltrated with the anesthetic solution, the fat is usually
completely numb. The infiltration of the local anesthetic is a slow
careful process that can take as long to complete as the liposuction
itself.
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Experience has shown that giving a sedative by mouth permits better
local anesthesia than when intravenous sedatives are used. This is
because an alert patient is more capable of detecting subtle areas of
incomplete anesthesia. A patient who is too sedated might easily
ignore an incompletely anesthetized area, and then feel more
discomfort later during liposuction. Therefore avoiding excessive
sedation actually maximizes patient comfort during liposuction.
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Liposuction is accomplished through tiny (1 to 2 millimeter) holes in
the skin, called adits. The adits are so small that they need not be
closed with stitches. After surgery adits remain open for 2 to 5 days
and facilitate the post-operative drainage of residual blood-tinged
anesthetic solution.
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After completing liposuction, absorbent pads are placed over the adits.
Finally, after the Liposuction Compression Garments are pulled on and
the IV is discontinued, you are ready to get up and go home. Because
of residual local anesthesia, it is several hours after completing the
liposuction before any significant soreness
Patients are not permitted to drive
themselves home after liposuction. Although most patients feel well
enough to drive a car immediately after surgery, you must not do so
because the large amounts of local anesthesia may cause some
drowsiness.
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Liposuction Areas
For liposuction purposes, the body is
divided into several areas: |
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Neck
As we
age, fat tends to collect in the neck and jowls. This causes a loss of
definition in the jaw line and is associated with a less youthful look.
Some individuals develop this problem earlier in life due to a family
trait. The so called turkey neck or waddle-neck abnormality is an
example of a family acquired abnormal fatty deposit.
Liposuction is a very effective means of removing this fat deposit. The
final result, however, depends upon the quality of skin and the
underlying neck muscle. The person's age, the presence of sun damage
and the amount of fat removed at liposuction all affect the final
appearance. Also, poor neck muscle configuration may affect final
appearance.
Neck
liposuction may be done as a separate procedure or, as is often the
case, performed with other areas of liposuction.
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Arms
The back part of a woman's arm is
different from the male arm. In women, there is a tendency to
accumulate fat which rarely occurs in men. In sleeveless dresses this
can make the woman appear more portly. Also, this abnormality can cause
the bust line to appear less shapely. Sometimes, the fat deposit is
large enough to cause clothing to fit too tightly around the arm making
it difficult to buy properly fitting clothes.
Liposuction can greatly improve this problem. Since the skin of the
upper arm usually contracts well after liposuction, the final result is
usually very good. The overall figure appears much slimmer and the bust
line is enhanced. Many women feel much more comfortable in swimwear or
sleeveless dresses.
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Dowager's Hump
This
fatty deposit occurs at the base of the neck or upper back. It is
sometimes referred to as a 'buffalo hump'. It can occur naturally or as
a result of medication. In addition to disturbing the body
configuration, it may limit the range of motion of the neck.
This
area can be removed by liposuction improving the neck/back body contour.
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Axillary Folds
This
is an increase of fat that produces a bulge above the brassiere line in
front and back of the arm pit. It adds to the appearance of obesity and
may also cause chafing of the skin. It suggests the brassiere is too
small/tight and can cause bulging underneath the woman's clothes.
Liposuction reduces this fat deposit giving better definition to the
breast.
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Male Breasts
Young men may have prominent breasts due
to increased breast and fibrous tissue causing prominence of the nipple
and breast. Mature men tend to accumulate fat in the breast due to
obesity and hormonal change with increasing age. Neither of these
conditions responds well to diet and exercise.
Liposuction reduces fat fairly well in this area. If marked fibrous
components are present, additional surgery may be required to augment
liposuction.
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Back
The back does not accumulate large amounts
of fat until weight gain is excessive. However, even a small amount of
fat may 'bulge' under the bra line giving the appearance of obesity in
an otherwise slender person.
Liposuction of
this area is often done in combination with other procedures.
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Abdomen
Changes in the abdominal contour are extremely common and abdominal
liposuction is one of the most requested procedures in both men and
women. Not only is this a prominent area contributing to the overall
figure, it is also important in one's appearance in sportswear/swimwear
and off-the-rack clothing.
Liposuction provides very good results in changing the abdominal contour
in properly selected cases. Terrific results occur in earlier cases
with good skin tone. However, good improvement can occur in a wide
range of individuals. Improvement in clothing fit and feel is an
additional benefit.
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Hips
Hips
are a natural fat storage area in women. This is influenced by weight
gain, hormonal influences and family traits. The hips are a major
determinant of how clothes fit and feel. It is a very common area
requested for liposuction.
Liposuction can completely reshape the
hips and totally redefine the back side of the trunk. In combination
with the abdomen, the entire torso is improved. When combined with
thigh liposuction, 'saddlebag' contours are improved.
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Flanks
The
flanks are a prominent fat storage area in men. With increasing weight
or age, the 'spare tire' contour is created. Even active men can
develop a 'spare tire' due to hormonal influences. It is a commonly
requested area of liposuction in men.
Liposuction causes good reduction of the spare tire problem giving a
younger, more athletic appearance to the male contour.
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Buttocks
Prominence of the
buttocks tends to run in families. It causes a prominent change in the
back side and profile of one's figure. More distressing is the problem
with making clothes fit properly.
Although the buttocks
can be easily liposuctioned, the degree of contour change is limited by
poor skin retraction if large volumes of fat are removed. Liposuction
can help but the patient must understand this limiting factor.
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Outer
Thigh
A slender properly
proportioned leg is usually associated with beauty and youth. Many men
are 'thigh men' and it is therefore a major focus of attention. In
pants, the thigh determines the fit of clothing. The outer thigh is a
major part of the saddlebag problem. For all these reasons, thigh
liposuction is common.
The outer thigh
responds well to liposuction and tapering of the outer thigh to match
the hips is an important aspect of body contouring. |
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Inner
Thigh
The inner thighs
sometimes have abnormal accumulations of fat. When this occurs,
rubbing of the inner thighs with walking/sports can lead to chronic
chafing. In pantyhose, friction between the thighs may produce a noise
when walking. Large inner thighs also contribute to an overall thigh
enlargement problem.
Inner thighs respond
well to liposuction. There is improvement of the fit of pant type
garments. |
Anterior Thigh
The anterior thigh is the front part of
the thigh. It is less commonly a problem than other parts of the
thigh. However prominent anterior thighs sometimes occur. Liposuction
in this area is usually requested in addition to other thigh problems.
Liposuction of the
anterior thigh greatly improves one's contour when viewed from the
profile position.
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Knee
Fatty deposits around
the knee tend to be a family pattern. Although less common, knee
liposuction is sometimes requested. This tends to be a more focal
problem than other areas of the body.
Liposuction can reduce knee fat. It is a more difficult area to
liposuction due to a prominent fibrous component in some individuals.
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Combinations
Liposuction of more
than one area of the body is often requested or indicated. Sometimes, a
person is concerned about more than one body area. Certain areas of the
body compliment each other and should be considered together, e.g.,
abdomen and hips.
Liposuction is a safe
and well tolerated procedure. However, there is a limit to the amount
of fat that can be safely removed at one time. This may restrict the
number of body areas that can be treated in a single procedure. Also,
liposuction of some combinations of body areas may not be as well
tolerated as other combinations.
With these limitations in mind, combinations of areas may be safely
approached with good results. However, sometimes serial liposuction
procedures will produce the best possible outcome and is more advisable.
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