Liposuction

Liposuction

Liposuction is one of the most popular cosmetic surgery procedures in the United States. The basic technique involves the localized removal of unwanted fat deposits from specific areas of the body. This is fat that is located between the skin and the muscle. This is considered to be a sculpturing procedure designed to recontour the body. Prima Center plastic surgeons, Dr. Zwiren and Dr. Nakano specialize in all aspects of body contour surgery in Atlanta. Our physicians keep up to date with all modern advancements in the field of body contouring procedures such as liposuction and lower body lifts. You can expect our plastic surgeons to guide you through the process of body contouring and to select the method for your procedure that is thought to give you the best result. Liposuction itself does not tighten the skin although at times it may seem tighter due to the pull from the surrounding tissues. Currently there are two methods of liposuction available, Tumescent Liposuction and Ultrasonic Assisted Liposuction.

Tumescent Liposuction — This is the most commonly used liposuction technique. This technique involves the introduction of a fluid solution into the fatty layer prior to suctioning. This fluid contains normal saline, local anesthetics (Lidocaine) and epinephrine (a vasoconstrictor). This fluid is injected into the fatty layer until it is tense and firm. This method makes the liposuction surgery more accurate along with decreasing bleeding and pain.

Ultrasonic assisted liposuction — This is a modification of current liposuction techniques. Using an ultrasound wave generator the fat is first liquified then removed by a low pressure suction. These sound waves are transmitted to the tip of the cannula. When this specially designed tip comes in contact with fat the cells are imploded and the fat content is emulsified. Since the fat is removed by a low pressure suction it is thought to be less traumatic than traditional liposuction. This method of liposuction is new to the United States, in fact the first machines were only released by the FDA in late 1997. The method has been used in Europe for many years with good results reported. During your consultation we will discuss the advantages and disadvantages of each technique and which technique would be the most appropriate in your individual situation.

Regardless of the type of liposuction done, the method is similar. A small 1/8 inch incision is made and the fat is removed by the use of small metal tubes called cannulas. Different sized tubes may be used in various body areas. The surgical procedure is usually done either under sedation (twilight anesthesia) or under general anesthesia ( all the way asleep). The procedure can be done either in our office operating room or in the outpatient area of the hospital.

The best candidates for liposuction are those who have dieted and exercised and have resistant areas of fat that no matter what your weight is these will not go away.

Important information about Liposuction

Location: Office or Outpatient Surgical Procedure

Anesthesia: Local with Sedation or General anesthesia

Length Of Surgery: Two to four hours depending upon the method used and number of sites

Location of Incision: Small incisions placed in inconspicuous areas

Technique: Traditional Tumescent vs. Ultrasonic Assisted

Garments: Post operative support garments are worn for 2 - 4 weeks

Cost of Liposuction: Varies depending upon the estimated length of the procedure. At the time of your consultation, the doctor will meet with you personally and you will be given a quote for the exact cost of your surgery.

Liposuction FAQ

What is Liposuction?

Liposuction is a procedure that sculpts the body by removing unwanted fat from specific areas including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck.

How does the procedure work?

There are several different methods of performing Liposuction, but the basic procedure works by making a tiny incision, inserting a narrow tube, or cannula, and suctioning the fat that lies deep beneath the skin.

How do the different types of liposuction work?

• Tumescent Liposuction – This technique involves injecting a solution of intravenous fluid, lidocaine and ephinephrine prior to liposuction. The fluid aids the surgeon in removing fat, controls pain during and after the procedure and dramatically reduces blood loss. Depending on the ratio of fluid used, this technique may also be called “wet” or “superwet”. Both UAL and PAL are types of Tumescent Liposuction.
• Ultrasound-Assisted Lipoplasty (UAL) – In this procedure, a special cannula or probe concentrates ultrasonic energy at its tip. As it passes through the areas of fatty tissue, the energy expands the walls of the fat cells, liquefying the fat. The fatty tissue is then removed with the traditional vacuum liposuction technique. UAL has been shown to improve the ease and effectiveness of liposuction in fibrous parts of the body and is also commonly used in secondary procedures to overcome the challenge of removing fat tissue from previously scarred fat deposits.
• Power-Assisted Liposculpture (PAL) – In this procedure, the cannula used for fat extraction has a rapid but small back and forth motion which assists in effective fat removal and reduces surgeon fatigue.

Is Liposuction safe?

Liposuction is safe, but rare complications may occur. The more areas treated at the same time and the larger the area, the greater the risk of complications. There is a chance of infection, delays in healing or the formation of blood clots (DVT). There is also a small risk of excessive fluid loss, which can lead to dehydration and shock, and a risk of fluid gain, which can lead to respiratory and cardiac problems. However, these problems are rare. Fat clots can also cause respiratory difficulty, but this is a rare phenomenon. Seromas, the accumulation of pockets of fluid, do tend to occur in certain areas and with greater volumes of suction. These are usually easily treated by simple aspiration with a small needle and syringe in the office.

Are there any possible side effects?

There are a few side effects that may occur in some instances with Liposuction, including skin depressions, hyperpigmentation, scarring and swelling.

Will there be any downtime?

Downtime varies according the extent of surgery and areas suctioned. A typical patient should expect a few days of downtime, and some bruising should be expected for one to three weeks.

What are the results?

The results vary for different procedures; however, there will always be less fat in the treated areas. If fat is regained after surgery, it is more commonly spread evenly across the body as opposed to collecting in the former problem zones.

What can be expected post-treatment?

Healing is a gradual process. Walking around as soon as possible is important, because it helps prevent blood clots from forming in the legs. After a couple of days, it will be possible to return to work. Some patients will require suture removal at about a week. Strenuous activities should be avoided for about a month to allow the body to fully heal. Your doctor will schedule follow-up visits to monitor recovery.

Who are candidates for Liposuction?

Candidates for liposuction are anyone within a normal weight range who has firm, elastic skin with pockets of excess fat they wish to be removed. Patients who are overweight may also be good candidates as long as they are in good general health, are at a stable weight and have realistic expectations.

Who should avoid Liposuction?

Individuals with medical problems such as diabetes, heart or lung disease, poor blood circulation or those who have recently had surgery near the area to be contoured may want to reconsider liposuction. These issues increase the risk factors of liposuction.

Is additional treatment necessary?

Additional treatment may be necessary to improve asymmetry or to fine tune the result. With a healthy diet and exercise, patients can keep the weight off.

Where are the treatments provided?

Treatments are provided in a surgeon’s office-based facility, an outpatient surgery center or a hospital. Most liposuction can be done as an outpatient procedure. Patients undergoing large volume liposuction of more than five liters may require a hospital stay for monitoring.

Instructions for before treatment:

The patient’s doctor will provide specific instructions prior to surgery. There will be guidelines on eating, drinking, smoking and medications to take and avoid. Patients should make arrangements for someone to drive them home after the surgery.

Instructions for after treatment:

Depending on the extent of your surgery, you may require a day or two of rest. It is recommended that you engage in light activity once you feel able. Expect some bruising, swelling and pain. Wear your compression garments all day and all night for two weeks, except when showering. Follow your physician’s instructions with regard to compression garments thereafter.