Liposuction is a technique to remove localized excess areas of fat – in both the moderately heavy and even the very thin – so that proportion and balance is created. Liposuction has been around for just about forty years now, and has become the most commonly performed cosmetic surgical procedure in the United States. Liposuction, suction assisted lipectomy, liposculpture, liposurgery, and lipoplasty are all words that describe the same procedure. External ultrasound has been shown to decrease the swelling and bruising after surgery, and for some this may be of benefit. Internal ultrasonic liposuction can be performed on select patients in fibrous areas to reduce swelling.
PATIENT SELECTION
With our increased understanding of fat metabolism, we now know that heredity and hormonal influences along with lifestyle account for these problem areas. Each of us is born with a genetically predetermined number of fat cells. The local concentration of these cells and the extent to which they absorb and hold fat is largely hereditary. Pinching an area of your skin between your thumb and forefinger will give you a good idea of the amount of fat concentrated under the skin.
A certain amount of fat is important to our well being. Directly under the skin is a layer known as metabolic fat. Encasing blood vessels and nerves that nourish the skin, this layer of fat gives it a smooth contour while providing warmth. Between this metabolic layer and muscle tissue is storage fat. It is this storage fat which collects in isolated areas such as the neck, stomach, waist, hips, thighs, and knees which proves most bothersome to patients and responds best to liposuction.
It is easy to appreciate how the thin person with love handles is appropriate for liposuction, but so too is the moderately heavy person whose love handles are out of proportion to the rest of their body. The goal of liposuction is to put the patient back into proportion and create an artful symmetry in the body. If the patient gains or loses weight, they will continue to maintain the proportion given to them by their surgeon.
It is commonly stated that liposuction is not a treatment for obesity, and that statement is true. However, liposuction can be appropriate for an overweight person if there is an area of excess that needs to be reduced to put the body in proportion. But liposuction cannot diffusely remove fat throughout the body in someone who does not have any localized excessive deposits. Liposuction can help many patients look better not just by the actual fat removed, but by the trickle-down effects of the improvement in a patient’s self-image. Self esteem and confidence are improved, people feel better about themselves, and tend to be more enthusiastic about the gym and good nutrition. Additional weight loss can therefore follow liposuction.
THE PROCEDURE
The most commonly suctioned areas are the neck (underneath the chin), tummy, waist, love handles, hips, saddle bags, inner thighs, knees, and, infrequently, the ankles. During the procedure you are completely awake, allowing you to lie down and stand up. Everyone is aware that their body appears differently when they are standing vs. lying, and by having you stand I can more accurately sculpt the body proportions. Pre-operative valium will help minimize any anxiety and discomfort you may feel. A special tumescent solution will be injected. This will numb the area as well as put fluid around the fat cells so they are more easily removed.
The procedure is performed through inconspicuous 1/4″ incisions that are often hidden in crease lines. A long thin tube, approximately half the width and twice the length of a pencil with specially shaped holes located along the tip, is connected by tubing to a very specialized high suction machine and introduced under the skin. A separate machine, external ultrasound, may be applied to the outside of the skin. I may use this method to aid in creating the best result and to decrease swelling and bruising. To avoid dimples and injury to the nerves and blood vessels containing “metabolic fat,” only the lower layer of storage fat near the muscle is suctioned away. You will leave with a compression girdle on which must be worn for the first two weeks. Thereafter, depending upon the site, you may switch to a lighter girdle which should be worn for another two weeks.
Because of fluid retention, you may not see much difference for the first few days following surgery, and you may notice bruising with deeper suctioning. If only a small amount was removed, the swelling may be as much as the volume removed, so little change may be noted right away. When larger amounts are removed, patients notice the results sooner. The change in your appearance, however, will become increasingly evident over the next few months. Although some leg or ankle swelling beginning a few days after surgery is not unusual, any pain or tenderness in the calves should be immediately reported to the office. Normal healing, however, takes its course over four to six weeks. You may even note improvement for up to a year as swelling resolves.
Santa Monica Board Certified dermatologist offers liposuction in New York. Suction assisted lipectomy, liposculpture, liposurgery, and lipoplasty are all words that describe the same procedure. Learn more about this cosmetic surgery procedure and Dr. Karyn Grossman.
