For generations, people have used various techniques to improve their
physical appearance. Although diet, exercise, and flattering clothing
styles help many look better, others remain dissatisfied because of
stubborn, unsightly bulges. In women, those fat deposits occur most
frequently from the waist down, on hips, buttocks, and outer thighs
(saddlebags). Fat deposits on men tend to accumulate above the waist,
on the abdomen and sides of the waist (love handles).
Now with a procedure called liposuction surgery, both men and women
can improve the contours of their bodies through a relatively simple
and safe technique. Liposuction surgery involves the removal of fat
cells from the body and may be used alone or in conjunction with other
procedures, such as facelift or "tummy tuck." It is designed for those
who have specific areas of localized fat deposits and who have tried
unsuccessfully to eliminate them through diet, exercise, and weight
loss.
While the procedure is not designed to correct general obesity, any
area where excess fat deposits have accumulated can be treated. These
include the chin, neck, jowls, cheeks, arms, inner and outer thighs,
buttocks, knees, hips, and abdomen. (Fig. A) Men with enlarged breasts,
a condition called gynecomastia, can also benefit from this technique.
Men and women in good physical condition with good skin elasticity
are the best candidates for this surgery. When the procedure was first
introduced, only younger people were considered to be good candidates;
however, recent improvements in the technique have made it possible
to treat patients of all ages. Each person seeking this treatment,
regardless of age, must be personally assessed by the physician to
determine if he or she is a suitable candidate for liposuction surgery.
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| Before Liposuction (Fig. A) |
After Liposuction |
Before Surgery
Prior to surgery a complete medical history is taken in order to
evaluate the general health of the patient. A thorough examination
is also conducted. The physician describes the type of anesthesia
to be used, the procedure, what results might realistically be expected,
and possible risks and complications.
Preoperative directions may include the elimination of certain drugs
which contain aspirin in order to minimize the possibility of excess
bleeding. Antibiotics may be prescribed prior to surgery to prevent
infection. Photographs are often taken before and after surgery
in order to evaluate the final results. The areas to be contoured
are marked with a special marking pen.
The Procedure
Liposuction surgery can be performed in the physicians office, an
outpatient surgical facility, or a hospital, depending on the physician's
and patient's preference. It can be done under general anesthesia
with the patient asleep or under local anesthesia in which the area
is numbed and the patient remains awake. Pre-medication is administered
to help the patient relax. When performing what is known as the
"tumescent" procedure, the physician injects a large amount of diluted
local anesthetic solution into the area. This procedure has the
advantage of reducing pain and bruising in the area.
The physician then makes a small incision in the skin and inserts
a tube (cannula) either attached to a high pressure vacuum suction
(Fig. B) or to a syringe system. The fat is loosened from surrounding
tissue by moving the tube back and forth and is then removed or
vacuumed from the body with the suction device. The physician determines
the amount of fat to remove by feeling the skin and pinching the
tissue.
Fig. B
Some physicians are now using ultrasound-assisted lipoplasty (UAL),
which significantly differs from traditional liposuction. In UAL,
mechanical sound waves are transmitted via a generator to the tip
of a suction cannula. When this cannula comes in contact with fat
cells, it causes them to emulsify or to become fluid.
The liquefied fat is then removed from the body by suction. UAL
has the additional risk of causing burns to the area and it's long
term effects are unknown at this time.
After the incisions are closed, a compression dressing or bandage
is applied to the area to prevent bleeding, reduce swelling, and
support the affected area. The procedure can last from thirty minutes
to several hours depending upon the amount of fat removed.
Following Surgery
The dressing remains in place for seven to ten days depending upon
the extent of the surgery and the individual's healing process.
A surgical compression garment may also be worn. Because liposuction
surgery does not involve large incisions and extensive cutting,
pain is minimal to moderate and is controlled with oral medication.
Antibiotics may be prescribed to prevent infection.
Most patients are completely ambulatory immediately following surgery,
but rest is recommended for the initial postoperative period. Patients
are usually able to return to normal activities within a week although
vigorous physical activity is discouraged for several weeks.
Some swelling and discoloration can occur but usually disappear
within a month. Scars, which fade significantly with time, are,
for the most part, inconspicuous because they are made within the
natural creases of the body whenever possible.
Complications connected with this surgery are rare; however, an
uneven skin surface, bleeding, infection, numbness, and discoloration
can occur. Some of these conditions correct themselves in time;
others respond to medications. There are certain inherent risks
connected with every surgical procedure which should be discussed
with the physician. Patients can minimize complications by carefully
following directions given by the physician.
It is important to remember that liposuction surgery, while not
a cure for generalized obesity, is an excellent procedure that can
benefit those who want to remove unsightly fat from localized areas.
Patients who choose this type of surgery, however, must have realistic
expectations about the outcome and understand that final results
may not be apparent for up to one year.
Copyright © 1997 Contemporary Health Communications,
Chesterfield, Missouri (Commercial use strictly prohibited)
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