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If you're considering liposuction....
Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as "lipoplasty" or "suction lipectomy," has benefited from several new refinements.
At the Plastic Surgery Clinic we perform approximately 150 to 200 liposuction procedures per year. This makes Dr Lista one of the most experienced liposuction surgeons in Ontario, Canada. Dr Lista has one main philosophy when performing liposuction: to make all his liposuction patients look soft and natural and perform the operation as safely as possible. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping many plastic surgeons to provide selected patients with more precise results and quicker recovery times.
The newest form of liposuction, Power Assisted Liposuction (PAL), removes fat with less bruising and even faster recovery. Dr Lista at the Plastic Surgery Clinic is one of the first surgeons to begin using PAL in Canada.
Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don't respond to traditional weight-loss methods.
The best candidates for liposuction
To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. It's important to understand that liposuction can enhance your appearance and self confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.
Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.
The Office Visit
Dr Lista prefers to see all his patients at least twice before surgery. In the consultation process we spend considerable time obtaining a careful history and physical examination. We also spend a long time discussing the patient’s desires, goals and expectations. It is important that the patient discuss with Dr Lista their desired result. Not all expectations can be accomplished with surgery and it is important that these issues are carefully discussed before surgery. Photographs can be helpful in this regard and at The Plastic Surgery Clinic we have computerized digital imaging, which allows Dr Lista to show the patients examples of how they may look after surgery.
How Liposuction is performed
Most liposuction procedures are performed at The Plastic Surgery Clinic. Dr Lista performs all of the procedures personally. He does not have any assistants or students assist with your surgery. Dr Lista is Chief of Plastic Surgery at the Trillium Health Center (The Mississauga Hospital) so your operation can also be performed at the hospital if you prefer. The operation is performed either at our clinic or in the hospital. At the Plastic Surgery Clinic anesthetics are administered by specialist physicians who are board certified in the specialty of anesthesia. These doctors give the anesthetic, stay with the patient during the entire operation and are with the patient while they are waking up. The operation takes one to two hours. A friend or relative will need to come and pick you up and stay with you for 24 hours.
Anesthesia for liposuction
Various types of anesthesia can be used for liposuction procedures. Together, you and Dr Lista will select the type of anesthesia that provides the safest and most effective level of comfort for your surgery.
If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under local anesthesia, which numbs only the affected areas. However, if you prefer, the local is usually used along with intravenous sedation to keep you more relaxed during the procedure. Regional anesthesia can be a good choice for more extensive procedures. One type of regional anesthesia is the epidural block, the same type of anesthesia commonly used in childbirth.
However, some patients prefer general anesthesia, particularly if a large volume of fat is being removed. If this is the case, a nurse anesthetist or anesthesiologist will be called in to make sure you are completely asleep during the procedure.
Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon's preference. If many sites are being treated, your surgeon will then move on to the next area, working to keep the incisions as inconspicuous as possible.
Fluid is lost along with the fat, and it's crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery.
The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.
Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid - a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) - helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.
The amount of fluid that is injected varies depending on the individual needs of each patient the specific area being liposuctioned.
Large volumes of fluid - sometimes as much as three times the amount of fat to be removed - are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as 4 to 5 hours). However, because the injected fluid contains an adequate amount of anesthetic, additional anesthesia may not be necessary. The name of this technique refers to the swollen and firm or "tumesced" state of the fatty tissues when they are filled with solution.
The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.
Power Assisted Liposuction(PAL)). This is the newest technique of liposuction and Dr Lista is one of the first surgeons in Canada to utilize this method. In this technique a power source is used to rapidly oscillate the liposuction cannula 3 or 4 millimeters at a frequency of several hundred cycles per second. This allows the fat to be removed with less force thus decreasing trauma to the patient. The fat is removed more quickly, more evenly and with less bleeding. This means that patients have less bruising and can recover more quickly following surgery.
You will have to wear a lycra garment which is like a pair of biking shorts for 6 weeks. We will provide this garment to you and you will wear it under your clothes like underwear. You can start to shower the day after surgery, wash the garment and then re-apply it. Patients need to take one week off after surgery. During this week off, the patient should stay fairly quiet at home. We suggest sitting around the house watching television, enjoying videos or reading. Patients with small children will need help at home. While this sounds excessive to some, staying quiet in the first week, actually speeds healing and helps obtain a good result from the surgery. Pain pills are prescribed to help reduce post-operative pain. Patients can gently exercise in about 2 weeks. This means walking, stair-master or treadmill walking is allowed but no running or high impact working out for one month.
All surgery carries some uncertainty and risk
Liposuction is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is adequately trained.
As a minimum, your surgeon should have basic (core) accredited surgical training with special training in body contouring. Also, even though many body-contouring procedures are performed outside the hospital setting, be certain that your surgeon has been granted privileges to perform liposuction at an accredited hospital.
Your doctor must have advanced surgical skills to perform procedures that involve the removal of a large amount of fat (more than 5 liters or 5,000 ccs); ask your doctor about his or her other patients who have had similar procedures and what their results were. Also, more extensive liposuction procedures require attentive after-care. Find out how your surgeon plans to monitor your condition closely after the procedure.
However, it's important to keep in mind that even though a well-trained surgeon and a state-of-the art facility can improve your chance of having a good result, there are no guarantees. Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations.
The combination of these factors can create greater hazards for infection; delays in healing; the formation of fat clots or blood clots, which may migrate to the lungs and cause death; excessive fluid loss, which can lead to shock or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavorable drug reactions.
There are also points to consider with the newer techniques. For example, in UAL, the heat from the ultrasound device used to liquefy the fat cells may cause injury to the skin or deeper tissues. Also, you should be aware that even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known.
In the tumescent and super-wet techniques, the anesthetic fluid that is injected may cause lidocaine toxicity (if the solution's lidocaine content is too high), or the collection of fluid in the lungs (if too much fluid is administered).
The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even "baggy," especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.
Your new look
You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.
If your expectations are realistic, you will probably be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.
Liposuction (or lipoplasty) is a body-sculpting procedure to remove fat that is unresponsive to dieting and exercising. This procedure can be applied to nearly any area of the body and is commonly used on multiple areas during an operation. Liposuction results in a slimmer and better proportioned figure. Liposuction is used effectively to reduce love handles, saddlebags, a double-chin, a bulge around the waistline, or other unsightly fatty deposits in order to develop a better shape and create a more beautiful body.
Reasons for Considering Liposuction:
Liposuction is not a replacement for proper exercise and diet. Instead, liposuction is a reduction procedure for stubborn areas where fat accumulates. Used in combination with several areas of the body, liposuction can provide a well proportioned body appearance. Ideal surgical candidates are those already in good physical condition but having stubborn areas that do not respond to diet and exercise.
Liposuction can be done under general anesthesia with the patient asleep or under local anesthesia where the area is numbed and the patient remains awake. Through a tiny incision, a narrow tube or “cannula” is inserted and used to vacuum out the fatty tissue beneath the skin. The surgeon determines the amount of fat to be removed by massaging the skin and squeezing the tissue. After eliminating the excess fat, the incisions are closed by applying a compression dressing or bandage to the area in order to prevent bleeding, reduce swelling, and support the affected area.
There are several different types of liposuction procedures, such as tumescent or ultrasound liposuction, that have developed as a result of recent advancements in new technologies. Together the patient and the surgeon can discuss which method(s) are best during the initial consultation visit. Liposuction can last from thirty minutes to several hours depending upon the amount of fat to be removed. Liposuction surgery is an excellent procedure that can benefit those who want to remove unattractive fatty deposits.
New techniques allow for faster recovery from liposuction procedures. The length of the recovery will depend on how extensive of an operation the patient undergoes. Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and reduce the recovery time. A support garment may need to be worn for several weeks after the surgery, depending upon which area(s) are selected to utilize the liposuction procedure. Patients sometimes report minor pain associated with surgery which can be treated effectively with oral medication. While complications are rare, patients can minimize the risk for potential problems by carefully following the directions given after surgery.