LIPOSUCTION - QUESTIONS AND ANSWERS
Because informed patients are so important to the success of any plastic surgery, Dr. Robert H. Stubbs, a Canadian and American Board Certified Plastic Surgeon has prepared this web info for you. The web info will give you a basic understanding of the procedure - when it can help, how it is performed and what results you can expect. It can not answer all your questions, since a lot depends on the individual patient and the surgeon. Please ask a certified Plastic Surgeon about anything you do not understand.
Q: WHAT IS LIPOSUCTION?
A: Liposuction is a surgical procedure which removes unwanted fat deposits from specific areas of the body, including the neck, the upper arms, the breasts, the abdomen and flanks, the buttocks, hips and thighs, the knees and occasionally the calves and ankles. Liposuction is not performed for weight reduction. It is a technique for removing localized fat that does not respond to dieting and exercise. Small amounts of fat reduction can improve body proportion, and in so doing, make the individual look less heavy.
Q: WHO ARE THE BEST CANDIDATES FOR LIPOSUCTION?
A: Liposuction, like other cosmetic procedures, can enhance your appearance and your self-confidence. Liposuction 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 - they must be realistic.
The best candidates for liposuction are within their ideal weight range and have excess fat in localized areas with good skin tone. Patients should be physically healthy, psychologically stable, and realistic. Firm elastic skin produces a better result. Loose, drooping skin will not reshape to your body's new contours after liposuction. Some patients with poor skin tone are prepared to accept post-op skin irregularities as their goals are simply to fit clothing better. Other procedures, which leave scars, are available to remove excess skin for those who wish tighter skin.
Liposuction is contraindicated if you have had recent surgery in the region. Also, if you have poor blood circulation in that area, or if you have heart, lung or uncontrolled diabetic disease. Smokers always heal more poorly than non-smokers! Liposuction will not improve dimpled skin. "Cellulite" is not a disease. It is a natural dimpling caused by fibrous bands which stabilize the skin to the underlying connective tissue.
Q: WHAT ARE THE RISKS?
A: 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 a certified Plastic Surgeon. See the Special Consent to Liposuction.
Q: WHAT HAPPENS BEFORE SURGERY?
A: Most patients are seen at least twice before surgery. At the initial consultation, we evaluate your health, determine where your fat deposits lie and assess your skin tone. Costs, timing and location are reviewed.
During this consultation, be sure to tell us about any medications (especially aspirin or other pills that affect clotting), vitamins or other drugs you are taking. Smokers should consider giving up the habit before and after surgery. Then, a complete physical along with blood and urine analysis is arranged.
At the next consultation, or informed consent visit, the patient who is a suitable candidate has a chance to discuss the risks again or other details prior to the actual day of surgery.
Q: WHAT HAPPENS ON THE DAY OF SURGERY?
A: The patient should not have had anything to eat or drink after midnight prior to surgery. Pre-op medications should have been taken. Also, transportation and post-op care arrangements should have been made.
Most liposuction procedures are performed under deep sedation and local anesthesia. Small areas can be gently "frozen" and done without the need for sedation. Liposuction usually takes an hour or two, but the time required may vary considerably depending on the amount of work being done. During this time the patient is carefully monitored.
To begin the procedure, a small incision, just large enough to allow the insertion of a hollow tube called a cannula is made. The opposite end of the cannula is attached to a vacuum device. This may be a machine or a hand held syringe. The cannula is manipulated deep within the fat layers under the skin, breaking up the fat and suctioning it out.
Body fluid loss which occurs along with the fat removal is replaced via intravenous fluids or by injecting large quantities of fluid into the specific areas prior to suctioning (tumescent technique).
At the end of surgery, the incisions are closed, a light dressing is applied and a compression garment is fitted. The patient is then monitored in the recovery area for a few hours prior to discharge. It is mandatory for a patient who has had deep sedation to have someone stay with them the first night after surgery. The medications may affect judgment and co-ordination for 24 hours.
Q: WHAT HAPPENS AFTER SURGERY?
A: Follow-up visits vary according to the patient and the procedure. Most patients are seen again within one week.
Early post-op instructions usually include taking prescribed medications, wearing the elastic compression garment and ambulating (to prevent blood clots).
A snug elastic dressing, girdle or body stocking must be worn over the treated area to control swelling and bleeding, and to help your skin shrink to fit your new contour. You may need to wear this garment continuously for up to six weeks.
Patients should not expect an immediate result. At first, you are going to look much worse than before. The suctioned areas will be swollen and bruised and you may feel a burning sensation. The discomfort can be controlled with pain medications. You often feel stiff and sore for a few days. Temporary loss of feeling in the suctioned area is sometimes noted.
Most patients are quite active a few days after surgery and many are back to work or school within a week. The healing process is gradual. While most of the swelling and discoloration will be gone a month or two after surgery, some swelling can remain for six months or more.
Further follow-up is usually scheduled for six weeks and then six months after surgery. If you have any unusual symptoms between visits or any questions about what you can or can not do, do not hesitate to call us. Strenuous activities are best avoided for at least 4-6 weeks post-op. After this, although the compression garment is not necessary, many patients prefer to wear it under their spandex exercise outfits during periods of heavy training or unpredictable sporting events.
Q: WHAT ARE THE RESULTS?
A: Liposuction is an excellent technique for giving you a new body contour with very little scarring. The results are permanent. Most patients are very satisfied with the results of their liposuction - they feel more comfortable in a wide variety of clothes and more at ease with their bodies. As long as your expectations are realistic, you should be very happy with your new shape. See the Surgical Art Gallery for examples of this procedure.
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