Liposculpture, the art of suction-assisted lipectomy otherwise known as liposuction is a procedure used to improve the body's contour by removing fat deposits that lie between the skin and muscle. Fat cells are permanently removed from the directed area. As simple as this may seem, this apparent simplicity is deceptive. Liposuction facial and body contouring otherwise known as liposculpture demands from the surgeon not only excellent technical ability but also a particularly acute artistic sense. Liposuction is not a substitute for weight control or exercise, but a method of removing localized fat.
The most frequently treated areas in women are the chin, abdomen, thighs, hips, knees, arms, buttocks, calves and ankles. Men typically have liposuction performed on the neck, chin, abdomen, "love handles" and breasts.
The Liposuction Procedure
The liposuction procedure involves making small incisions to insert a hollow tube, called a cannula. Fluid is added to reduce bleeding and pain (tumescent liposuction). Excess fat is then removed through the tube until a pleasing improvement is made. Several areas may be suctioned during one procedure. Suctioning is often combined with other procedures such as breast surgery and abdominoplasty. It may be used during a facelift to contour the neck and chin.
Types of Liposuction
Liposuction was first performed in Europe in the late 1970s. It has become one of the most commonly performed surgical procedures in the United States. There have been four major advances over the past two decades:
Smaller instruments give the surgeon more control.
The tumescent technique involves distending the fat with water before removing it. This causes less bleeding and thus less postoperative bruising. The fluid also makes the fat softer and easier to remove thus adding additional control.
Power assisted liposuction improves sculpting technique and decreased procedure time.
Ultrasonic Assisted Liposuction (UAL). Patented VASER® technology and the advanced LipoSelection® technique now offer a safe alternative for ridding yourself of stubborn fat deposits to provide a smooth new shape with fast recovery. VASER LipoSelection® is a minimally invasive procedure that precisely and efficiently removes unwanted body fat. An alternative to the harsh techniques of traditional liposuction, VASER LipoSelection® uses state-of-the-art ultrasound technology designed to gently reshape your body. What distinguishes the LipoSelection procedure is its ability to differentiate targeted fat from other important tissues - such as nerves, blood vessels and connective tissue. Innovative VASER® technology breaks up fat while conserving these other important tissues. The LipoSelection procedure uses the proprietary VASER System to first liquefy fat and then remove it from the body to promote smooth results and rapid healing with only low to minimal pain. Although there are limits to the amount of fat that can be removed, Dr. Tehrani can assist with the decision about potential areas for contouring, anticipated results, and the recovery process.
Laser-Assisted Liposuction (Laser Assisted Lipoplasty - LAL) is an innovative new procedure for removing excess body fat and firming loose skin. In this minimally invasive procedure, a single laser fiber is introduced into the body through a small cannula, fat cells are literally melted away, removing stubborn fat deposits, tightening and toning the skin in the process. Laser liposuction popularly known as SmartLipo also tightens the skin, eliminating sagginess and giving it a youthful firmness. The entire laser liposuction process usually takes less than an hour for each targeted area and can be performed under local anesthesia. It involves a very short recovery time, with most patients being able to return to work and normal activities within a day or two.
Benefits of Liposuction
There are no substitutes for eating properly and exercising regularly. However, many patients seek Dr. Tehrani's help when, in spite of a low fat diet and a regular exercise routine, they continue to have sites of disproportionate fat accumulation. The medical term for this condition is lipodystrophy. Lipodystrophy can be corrected with liposuction, the single most significant advance in plastic surgery over the past twenty-five years. Prior to liposuction, body contouring was rarely performed and involved extensive, very visible scars.
Who is a candidate for liposuction?
Candidates include men and women who are in good physical and mental health, yet have areas of excess fat. Having firm and elastic skin will result in a better final contour. Liposuction is not a substitute for weight reduction.
A good candidate for liposuction is of relatively normal weight with one or more areas of excess fat deposit. The most common areas for liposuction in women are the inner or outer thighs, the knees, the hips, the abdomen, the upper arms, and the chin. In men, the most common areas are the chin, waist and abdomen. Most patients have several different areas which are problematic, and these can usually all be removed simultaneously.
Your skin must be reasonably elastic. This allows the skin to assume the new contour after the fat has been removed. This determination is made before the surgery is performed. Those patients who have experienced very large fluctuations in their body weight are often poor candidates for liposuction. The quality of their skin in most instances is very poor, lacking the necessary elasticity.
Although liposuction can change the shape of your body, if you have cellulite, the surface irregularities will not be changed. Cellulite is caused by connective tissue attachments between the skin and the underlying tissues. Between these attachments is a dense, fibrous form of fat. This more superficial fat is not removed by liposuction. Doing so might impair the circulation to the skin and cause scarring.
In order to be a good candidate for liposuction, you must be physically and psychologically healthy and have realistic expectations.
At your initial consultation, Dr. Tehrani will ask you to express your concerns about your appearance. Your medical history will be reviewed and a physical examination will be conducted to determine if a surgical procedure is best for you. If you are a good candidate for surgery, Dr. Tehrani will explain what can be done to assist you.
Dr. Tehrani may request that you visit your private medical doctor for a check-up and for any necessary lab work and x-rays. Precise preoperative instructions are provided, and all necessary prescriptions are given to you in advance of the surgery. All aspirin, aspirin-containing products, and anti-inflammatory products must be stopped at least ten days before and for ten days after surgery. You will be provided with a complete list of which medications to avoid. Tylenol may be taken during this time. Also, you will be given a list of vitamins and homeopathic preparations to take prior to and after the surgery. This is done to promote healing and limit bruising.
In the vast majority of liposuction cases, general anesthesia is used. However, in some cases, local anesthesia with intravenous sedation may be used. Dr. Tehrani and our anesthesiologists will help you make this decision based on what type of anesthesia is best for you.
Liposuction is generally performed as an outpatient procedure. It may be combined with other procedures, such as cosmetic facial or breast surgery.
Before anesthesia is given, a detailed "map" of the fat to be removed is drawn on your skin using a special marking pen.
After anesthesia is given, Dr. Tehrani will inject a dilute solution of water, saline and local anesthesia to distend the fat (tumescent technique). The solution works on the fat for seven minutes before the liposculpting is begun. Very small (1/4 inch) incisions are made in inconspicuous areas such as the navel or the crease behind the buttocks. A thin hollow tube called a "cannula" is inserted into the fat. The cannula is attached to a clear plastic tubing and connected to a vacuum device. By working the cannula through the fat while ultrasound and suction are applied, Dr. Tehrani will remove the unwanted fat and proceeds layer by layer until the desired shape is achieved. The incisions are then closed with one or two small stitches. You are then fitted for an elastic garment, awakened and taken to the recovery room.
The time required to perform liposuction varies considerably, depending on the number of areas and the amount of fat to be removed.
The Postoperative Period
The first one to two hours after surgery are spent in the recovery room. When you are fully alert, you will be able to return home in the care of a friend or family member. A private nurse can be provided at your request. Instructions are given on how to care for the incisions until the stitches are removed in seven days.
A snug elastic garment or body stocking must be worn over the treated area for two to three weeks. This is done not only to control swelling and bruising, but also to minimize postoperative pain. Most patients describe the pain following liposuction as mild. Some feel as if they had exercised strenuously. Pain medication is prescribed, although this is usually unnecessary after the first day.
Bruising, if present, can persist for a week or more. Swelling, however, may persist longer. The final result may not be evident for six to eight weeks. However, most of the swelling resolves in a matter of two weeks.
You will be encouraged to begin walking short distances within the first several days after surgery. Most patients can return to work or social activities after four to seven days. Strenuous activity such as running, aerobics, weight training, swimming or tennis must be avoided for two weeks after surgery.
Liposuction is a highly effective method of giving your body a new contour with minimal, unnoticeable scarring. The results are permanent. Liposuction removes fat cells that will not come back, since no new fat cells are produced after puberty.
If you gain weight after liposuction, the fat will be distributed more uniformly throughout your body. It will not accumulate disproportionately in the former "bulges."