What is Liposuction? - Do you really know about Liposuction..?

How many artists and celebrities can remain so thin?




Without doubt, many of them are the traditional way, adhering to strict diets and exercise programs. But at least some, they needed to leave their thinner thighs, abdomen and hips more defined in clinics for plastic surgery and liposuction, even if they are reluctant to admit it.



The celebrities are not the only people who want a more stripped down body through liposuction surgery.



It is estimated that doctors do some of 500 thousand of liposuction surgeries per year in the United States, making it the type of plastic surgery more popular, according to the American Society of Dermatologic Surgery (in English).



In this hub, we'll see how it's done the liposuction, learn how the procedure and discover the risks involved in the process.



Most people know that involves liposuction to remove fat from certain parts of the body to create a better appearance.



But how exactly does it work and what is liposuction?







liposuction



Fat



what is fat?

It is the fabric (also known as adipose tissue) formed from cells that store energy and isolating (in terms of temperature) the body.



The subcutaneous fat is usually - located under the skin. The place where the fat is stored around the body varies depending on the age of the person. In men, fat tends to concentrate in the chest, abdomen and buttocks.



In women, usually accumulate in the breasts, hips, waist and buttocks. There are two layers of subcutaneous fat: the deep and superficial.



During the process of liposuction (also known as liposuction or liposculpture-sucking), the doctor makes a small incision and inserting a tube of stainless steel, (called a cannula) into the deep layer of fat.



Working in this layer is safer than working in the surface layer, because there is less risk of hurting the skin. In typical procedures, the doctor pushes and pulls the tube through the layer of fat (a new technique, the automated liposuction, makes these movements alone). As the tube moves, it breaks the fat cells, and a vacuum pump or a syringe to remove fat using suction.



The liposuction is commonly used for cosmetic purposes, to give a visual more smooth and graceful in regions such as the thighs, the abdomen, the buttocks, the waist, the calf, the arms or the back - regions that have not responded well to diet and exercise .



Liposuction It can also be used to reduce the size of male breasts or to remove accumulation of fat located and lipomas.



The fat can be removed over a part of the body during a single surgical procedure. It is important to realize that liposuction is not a technique for weight loss; is just a technique of remodeling.



Only diet and exercise can result in a loss of actual weight.

Doctors




Doctors who do liposuction

Liposuction is not a medical specialty, and no specialized training is required, meaning that any doctor licensed, including plastic surgeons and dermatologists can do it.



The FDA (Food and Drug Administration - U.S.) recommends that you ask if your doctor has proper training to perform liposuction. It is also a good idea ask your doctor how many procedures already performed.



And do not be indecisive about the promise of wonderful results - if they seem to be as good to be true, they probably are.



Who are the best candidates for liposuction?

Having excess fat is not necessarily a factor which makes it a good candidate for a liposuction. In fact, the opposite is true.



People with normal weight and generally in good shape and that almost never had any problem, are the best candidates, because their skin is firm and elastic. If the skin is not elastic enough, it will fall after the procedure.



Therefore, in patients over the age result is not the same as in younger patients. You need to be in good physical shape so that the liposuction surgery goes well.



Anyone who has diabetes, heart condition, poor circulation, infection, bleeding or a history of clotting disorders such as thrombophilia, should consult their GP before passing through a liposuction procedure.



The liposuction is not recommended for people who are taking any medication that interfere with blood clotting, affinity of blood as aspirin, heparin and warfarin.



What is the cost of liposuction?

One of the considerations which involve the most in liposuction is the cost. The price varies according to the areas to be worked, the amount of fat removed, and the doctor who will do the procedure.



The average price of a liposuction in a part of the body ranges from $ 4 thousand to U.S. $ 7 thousand. In more than a part of the body, the cost increases of $ 2.4 thousand to U.S. $ 8 thousand.



There are additional costs, such as laboratory tests, anesthesia and the materials used in surgery.



Due to be considered a liposuction plastic surgery, the health plans do not cover this procedure.



But when performed for medical reasons, the removal of lipomas, for example, some insurance companies will cover the costs.



Liposuction surgery

Due to the fact that not all people will benefit from the same type of surgery, and that some people are not good candidates for this procedure, any surgery, liposuction begins with a consultation.



The doctor will assess your health (both physical and psychological) and determine if the elasticity of your skin and reservoirs of fat make it a good candidate.



Then the doctor will help you decide what kind of liposuction procedure is most appropriate for you.



The liposuction can be done in a surgical clinic, a medical center or a hospital. Liposuction procedures for minors are usually made and the patient can go home the same day, which tends to be less expensive.



Before the procedure, the doctor marks the skin to indicate the place where the fat is removed.



As in most surgeries, the need for a liposuction surgery. But the type of anesthesia depends on the amount of fat being removed.



For smaller areas, doctors use local anesthesia (which breaks the area around). Typically, the doctor administers a sedative, oral or injectable, along with local anesthesia to calm the patient.



Alternatively, the doctor applies in a patient epidural, which is intravenous and blocks the sensitivity of a whole part of the body (the waist down, for example).



General anesthesia should be used in hospitals when it is necessary to remove a large amount of fat, but not recommended by the American Academy of Dermatology.



In most liposuction procedures performed today, doctors inject a local anesthetic as part of the mixture of fluid. During the surgery, the doctor makes a small incision or several small incisions and insert the tube within the layers of fat in certain regions.



The tube moves quickly back and forth to remove the fat cells, which are sucked out - typically by using a device attached to a vacuum tube, and stored in a bottle.



The tube creates a tunnel in the layer of fat and needs to be undone healed and create a new way for the body.



For this reason, the patient must wear a compression garment after surgery. Due to the loss of fluids during the procedure, patients sometimes require application of intravenous fluids after surgery.



Techniques of liposuction

Doctors use various types of liposuction procedures. Read below about some of them.



Tumescent liposuction Developed by plastic surgeons in the 80s.



This has become the most common method of liposuction. He also is considered more secure than the other methods to limit the loss of blood and not always needs the replacement of intravenous fluids after the procedure. In this procedure, the doctor injects a large amount of fluid containing anesthetic (five times the amount of tissue to be removed) in the areas containing deposits of fat.



The fluid contains a local anesthetic (lidocaine), a drug that contracts blood vessels and reduces the loss of blood (epinephrine) and a saline solution that facilitates the removal of fat. The fluid makes the fat tissue increases in volume and becomes harder (get tumescent), it being easier to be removed with the cannula.



Because the fluid contains a relatively small amount of lidocaine, this procedure is performed with local anesthesia. Despite tend to be longer than other techniques - about 4 to 5 am - the tumescent liposuction has the advantage of reducing the swelling and pain after surgery.



"Super-wet"



This technique of liposucton is similar to tumescent, with the exception that it uses less fluid (the same amount of fluid to the amount of fat tissue removed).



Even though sometimes a small amount of lidocaine is added to the fluid, this technique usually requires a general or epidural anesthesia-IV.



The procedure lasts about 2 pm Assisted liposuction with ultrasound (UAL) This relatively new technique uses a special tube that vibrates very quickly and releases energy Ultrasonic.



As the cannula through the fat cells, this energy makes these cells become liquid, and then sucked. The ultrasound can be used both above (with a special transmitter) and beneath the surface of the skin (with a cannula Ultrasonic).



There are two kinds of tubes ultrasonic:



a solid probe a hollow probe The probe creates a solid concentration of tumescent solution and emulsifying fat under the skin, which is then removed with a suction tube standard.



The hollow probe emulsifica and removes the fat, but the doctors typically use a standard tube to remove the remaining fat emulsifying left by the probe (Sattler, 2005). The UAL takes longer to be procedure that other types of liposuction, but is more precise and tends to be more effective, especially in the removal of gorgura fibrous areas of the body, such as male chest and back.



The secret is that it generates an intense heat. If the tube is not removed fast enough, it can cause a burn.



Moreover, the doctors do not know the long-term effects of exposure to internal ultrasound. Liposuction automated Doctors have at your disposal an automatic cannula, which moves back and forth at high speed at a distance of 3 to 5 mm. It can remove about 40% more fat per minute that liposuction common, making the procedure is done in less time, in addition to having better results, according to doctors (Wagner, 2001). Rank">wait...



The history of liposuction

In 1975, researchers Italian Georgio and Arpad Fischer emerged with the idea of removing fat using hollow tubes connected to suction devices.



But his technique of liposuction "the dry" had many risks, mainly from blood loss and postoperative complications in as marks on the skin.



Later, Yves-Gerard Illouz, a French surgeon, developed a safer technique (wet), where he injetava a saline solution in the region to be operated to reduce the loss of blood and facilitate the removal of fat. In 1987, Jeffrey Klein, dermatologist in California, began with the tumescent technique, adding the anesthetic lidocaine in the solution injected. This is still the most widely used technique of liposuction today.



After the liposuction

If the patient is under local anesthesia, he usually returns to his home on the same day after surgery.



General anesthesia usually requires the patient to remain for a night in the hospital or the surgery center.



After the procedure, many patients do drainage of fluid on the spot where he was made to liposuction.



Sometimes, doctors need to insert tubes to facilitate drainage. Typically, patients wear an elastic compression garment at the site of surgery to compress the affected area to reduce swelling and speed up recovery.



Patients should also take antibiotics to prevent infection. See How to antibiotics. The items are removed and the incision is dissolved after 10 days. Many patients feel pain, damping or burning during the recovery process, but these symptoms usually disappear within three weeks.



Between four and six weeks later, the swelling has decreased enough to the results being seen. Patients need to avoid heavy exercise or other heavy activity for about a month after the procedure was performed.



The liposuction is permanent, but can not erase the obesity forever. If a person goes through a liposuction and keeps feeding the wrong way or do not exercise some, it will realize a bulge in the regions treated, and the fat will appear in other parts of the body.



This occurs in part because of a hormone called leptin, which is made of fatty cells. The levels of this hormone decrease when fat is removed.



This decrease causes an increase in appetite (causing the intake of food) until the levels rise again.



he problem is mainly found in people who were above the weight before surgery. To compensate for the loss of fat cells, their bodies produce more fat cells in other regions, and the fat begins to focus there.



The liposuction can be refeita if necessary, but there are no guarantees that the result is the same as the first procedure.



The Risks of Liposuction

Like any surgical procedure, the liposuction also has its risks.



This includes:



•infection;

•the formation of lumps of fat and blood clots that can loosen and go to the lungs (a potentially fatal condition known as pulmonary embolism);

•much loss of fluid, causing shock or even death;

•accumulation of fluid;

•causing damage to the nerve tingling or discomfort;

•swelling that can last several weeks or months after the procedure;

•death of the skin (necrosis), where they were to liposuction: beginning to scale and die and / or create an infection;

•burns due to the probe of ultrasound;

•punctures in organs, such as the bowel can be perforated during a liposuction abdomnal;

•drug reactions, including reactions to the fluid injected with lidocaine in Lipoesculpture and "super-wet";

•deformity under the skin where the doctor remove a lot of fat;

•scars, but the doctors do their best to keep the small and hidden scars.

In rare cases, the liposuction can lead to death.



Researchers of the issue have adverse opinions, but states is an average of 3 to 100 deaths for every 100 thousand of liposuction surgeries.

Liposuction vs Ultrasonic Liposuction vs Noninvasive Treatments

Body Contouring



The body fat is deposited in fat cells which have the ability to increase or decrease in volume according to greater or lesser amount of fat absorbed in its interior.


Beneath the skin there is a layer called the subcutaneous where most of the fat cells are located. There are also other regions that serve as a deposit such as within the abdominal cavity between the bowel. However most of the fat tissue (or fat) deposits in the subcutaneous tissue.

The degree of adiposity of a person depends on several factors.



Among them there are genetic factors and the type of diet.

•Genetic factors are undoubtedly important elements in the development of a deposit of more or less fat. There are real strains that predispose families to these localized deposits.

•The type of food is also an important factor in triggering an accumulation of fat. Poor eating habits no doubt can trigger obesity.

It is known that exercise and diet are able to trigger the burning of fat and encourage weight loss.

On the other hand, deposits of fat found in certain regions of the body are hardly capable of being corrected even with diets and/or exercises.

There are some classic examples:



•The lower abdominal region (below the navel). As the person progresses in age this deposit tends to grow.

•The region of the hips is another area that may also be the site of localized fat accumulation.

The study of these localized fat deposits has shown that exercise or even weight loss it is not enough to completely remove the amount of fat deposited there.

Liposuction


At the end of the '70s, a Frenchman named Illouz, reported a method for removal of localized fat through a procedure called liposuction.



This method is the introduction of a metal tube in the subcutaneous tissue that connected to a vacuum machine which sucks quantities of fat. As the tube is moved within the zone of accumulation the fat it is absorbed into the cannula and removed from the subcutaneous tissue. Thus, with this surgery is possible to withdraw more or less amount of fat within the areas of exaggerated deposit.

The liposuction is not a treatment for obesity. Rather serves to remove accumulations of fat found in certain regions of the body.



The total amount of fat to be removed should not be exaggerated as there is a certain amount of blood that is aspirated during the procedure of liposuction. If liposuction is very bulky the blood loss may also be causing anemia in the patient.

Indications:


The liposuction surgery is to reduce the amount of body fat in localized areas giving the patient a better body contour.



The liposuction is not made to lose weight because the biggest change occurs in the body silhouette and not on the scale.



The best results are obtained in liposuctions in which the patient has localized fat. Surgery in extensive areas and large volumes are more likely to leave irregularities.





Type of anesthesia:

Depends on the area to be operated and the amount of fat to be removed. Can be provided general anesthesia, local anesthesia or epidural anesthesia.





Postoperative:

Usually there is edema (swelling) and ecchymosis (bruises) which resolve themselves, in most cases, within 21 days.

During the 1st month after the liposuction the patient should experience remarkable improvement of the edema. An elastic strap to be used for 1.5 months and is indicated ultrasound and lymphatic drainage in order to accelerate recovery, reduce swelling and hardening.

Complications:

There are rare complications in liposuction but they can be cited: hematoma, irregularities, infection, stroke, accidents during surgery and anesthesia problems.

No doubt it is a delicate procedure that requires the full attention of the medical team involved in the operation.
However it is necessary to make a differentiation between complications of liposuction itself and the procedure involved in the anesthetic procedure.
Complications of liposuction itself are related to trauma or perforation of structures deep within the liposucked areas. Another complication of liposuction itself would be the presence of irregularities on the skin surface. In certain situations very superficial liposuction may also result in hyperchromia areas (darker areas) which can be corrected with decolorant substances.
It is also possible to happen cardiac arrest and death during liposuction surgeries.
You must understand that the anesthetic procedure (type of general anesthesia, local anesthesia or epidural anesthesia) may trigger complications.

Therefore, as already mentioned, it is essential to differentiate between the complications of liposuction itself and complications of anesthetic procedures involved.

The irregularities may be more or less corrected with a secondary liposuction.
Anesthesiology complications should have immediate treatment as soon as diagnosis is made.
In all these cases of complications is important to take into consideration that prophylaxis (avoid) is of utmost importance.

Ultrasonic Liposuction

In 1987 the Italian plastic surgeon Dr. Michele Zocchi developed ultrasonic liposuction.

This method was used to help dissolve the fat before its removal by suction techniques.
Due to complications of skin and tissue that burns the original ultrasonic liposuction fell into disuse. Today ultrasonic liposuction is often refer to some noninvasive treatments.

Noninvasive Treatments


These new treatments are nonsurgical procedures so they should not be compared with liposuction.
In fact they do not even suck the fat out. This treatments simply uses ultrasound waves to selectively break down fat cells without affecting adjacent structures.

UltraShape® Solution for fat loss


The UltraShape® it is not a liposuction but it works as such as it reduces the number of fat cells in the body without the inconveniences or complications of surgery.


The equipment has a very powerful high frequency convergent ultrasound which acts directly on the localized fat breaking the membranes of the adipose cells.

This happens because of the mechanical effect caused by the merging of the focalized ultrasound beams which provoke enough vibration to disrupt fat cell membrane without damaging the skin, blood vessels or peripheral nerves.

This action causes the fat to drop in the lymphatic system which will carry it through the liver.
At this point the fatty acids will be used as an energy source which will be spend by metabolic and physical activities.

Areas of the Body Treatable with Liposuction

Areas of the Body Treatable with Liposuction
Liposuction is not intended to be used strictly for weight loss. Rather, liposuction is most effective and beneficial when used to contour a patient’s overall figure by removing pockets of fat in specific areas that are resistant to diet and exercise. Liposuction can be very useful when performed on localized areas of the abdomen, flanks, hips, thigh area, buttocks, arms, and breasts.

DocShop can help you find a cosmetic surgeon in your area today.

Liposuction of the Abdomen
Liposuction is very effective for shaping the abdominal area in men and women. The lower abdomen in particular tends to be resistant to diet and exercise, making even the most fit and active individuals insecure about their appearance. Pregnancy and cesarean births can have a disfiguring effect on the lower abdomen, which diet and exercise cannot correct. Most abdominal fat is located directly beneath the skin (subcutaneous), and can easily be removed through liposuction procedures. However, fat that is located deep in the abdomen (between the intestines) cannot be removed with liposuction because of the increased risk of severe complications.

Liposuction of the Flanks
Male flanks are located just above the belt line on the sides and back. Liposuction can greatly improve the appearance of flanks and reduce the amount of fat that bulges over the belt. Liposuction in females addresses the flanks that are located just under the bra line on the sides and back.

Liposuction of the flanks should be done under local anesthetic, so that the patient can roll over and allow the surgeon access to the back of the flanks. It is dangerous to roll a patient who is under general anesthesia because the movement can interfere with the placement of the breathing tube.

Liposuction of the Hips
Liposuction of the hips is generally successful in creating a more contoured figure. This type of liposuction is usually performed on female hips as men are not as susceptible to retaining fat deposits in this area. Patients who undergo liposuction to improve the appearance of the hips may require additional procedures to attain the desired contour. The procedure is usually performed under general anesthesia.

Liposuction of the Thighs
Liposuction of the entire thigh (circumferential liposuction) is not recommended due to an increase in swelling and lengthened recovery time. Liposuction of the thighs should be performed in a series of surgeries spaced about one month apart. Focusing the liposuction on one targeted area of the hips allows the lymphatic tissue to drain excess fluids quickly and evenly throughout the thigh, yielding more desirable results in a shorter amount of time.

Liposuction of the Buttocks
It is important to remember when considering liposuction that shaping the buttocks is more important than reducing the size. Excess removal of fatty tissue in the buttocks can result in an asymmetrical, lumpy, or sagging appearance. The buttocks serve the functional purpose of acting as a soft cushion on which to sit, and are also important in the overall aesthetic appearance of the body. Surgeons should approach liposuction of the buttocks with the subtle touch of an artist, and should always use a micro-cannula, not more than three millimeters (1/8 inch) in diameter.

Liposuction of the Arms
Liposuction of the arms has a high rate of patient satisfaction. Liposuction of the arms yields a slimmer appearance that can give the rest of the body a more contoured look.

Liposuction of the Tummy
Liposuction of the tummy is a very common procedure for both men and women. It is especially useful in patients who have already lost excess weight through diet and exercise. Liposuction can, in many cases, be the only successful method of eliminating stubborn fat deposits that remain in the tummy region.

Liposuction of the Breasts
Enlarged breasts in women can cause back pain, neck pain, headaches, and poor self esteem. Liposuction is a more effective and less invasive method of breast reduction than other forms of breast reduction surgery. Using liposuction to remove excess fat has a natural lifting effect on the breast because it results in less volume weighing it down.

Liposuction of Male Breasts
Liposuction can also be used as a form of breast reduction in men, but several important factors must be considered first. The surgeon must determine whether the excess tissue in the breast is fatty or glandular. If the breast is primarily fatty tissue, then liposuction is an excellent method for reducing the size and improving the appearance of the chest.

If a man’s breasts are enlarged with glandular tissue, liposuction is not an option and other hormonal or medication therapies should be pursued. If the breasts are asymmetrical or oddly shaped, the patient should be examined for possible tumors prior to any surgical intervention. A mammogram is the most effective method for detecting tumors and the possible presence of male breast cancer. After proper testing has been conducted, a physician can help you determine the best course of action.

Facial Liposuction

Facial liposuction removes fatty deposits from specific areas of the face such as the chin, neck, and jowls. Facial liposuction rids patients of these excess fat deposits that make them look and feel older. A safe procedure with dramatic results, facial liposuction has helped thousands of people look and feel younger and more attractive.

DocShop can help you find a cosmetic surgeon in your area today.

Face, Neck, and Chin Liposuction
Facial liposuction is most often performed with a micro-cannula using a tumescent technique that involves injecting fluid into the targeted area while suctioning the fat out. In some cases, liposuction of the chin, neck, and jowls, as well as other facial liposuction procedures, can have better results in these problem areas than other surgical techniques. Facial liposuction can also be more desirable because it minimizes scarring when compared to other surgical techniques. Facial liposuction is usually performed on or below the chin and jaw line to reduce the appearance of sagging skin in the neck, a double-chin, or hanging jowls.

Who is a Good Candidate for Facial Liposuction?
The best candidate for facial liposuction is someone who wishes to remove bothersome pockets of fat but is within 30 percent of their ideal body weight. Age is not a major consideration in facial liposuction procedures, but those with more elastic qualities in their skin can expect to experience better results. For those who do not have elastic skin, other procedures such as a face lift can tighten the skin after fat has been removed using liposuction techniques. The best way to determine if you are a candidate for chin, neck, jowl, or any other type of facial liposuction procedure is to speak with an experienced surgeon.

Facial Liposuction Recovery
Recovery from facial liposuction is a relatively short process. Patients who have their chin, jowls, or neck treated with liposuction can expect to experience mild discomfort with some bruising or swelling. This should subside in about seven to ten days. Patients may require a few stitches to close the opening made by the cannula (the tube used to break up and remove fatty tissue). Most facial liposuction patients return to normal activities within one week and experience the full benefits of surgery within a three to six month period.

How to Prepare for Liposuction

How to Prepare for Liposuction
Though liposuction has become a common procedure for anyone wishing to eliminate stubborn deposits of fat that seem oblivious to diet or exercise, it is important to remember that liposuction is still surgery. Prospective patients can eliminate much of the anxiety associated with surgery by learning the basics of the process beforehand. This page serves as a primer for the procedure, providing information on what to expect and how to prepare for liposuction.

DocShop can help you find a cosmetic surgeon in your area today.

Schedule a Consultation with a Liposuction Surgeon
To prepare for liposuction surgery, your doctor will require you to meet for an in-depth planning session. During the meeting, you will discuss the entire procedure, its risks and limitations, and all steps you need to take prior to the operation. Your doctor will give you details about the kind of anesthesia he or she will use, the type of facility where the liposuction procedure will take place, the costs involved, and any medications or supplies you will need to pick up beforehand.

You and your doctor will also discuss your medical history and lifestyle to determine your risk during liposuction surgery. You will be asked about the drugs you are currently taking (prescription, over the counter, recreational, or herbal supplements), whether or not you smoke or take oral contraceptives, and any medical conditions you may have. It is crucial that you are honest with your doctor about any drugs you are taking, as this can greatly affect the outcome of your surgery.

Remember: this is your opportunity to ask any lingering questions you may have, or to express your anxieties or concerns about liposuction.

Two Weeks Prior to Liposuction Surgery
Two weeks prior to your liposuction surgery you should stop taking all forms of aspirin, as well as any medication and vitamins that could interfere with your blood’s clotting ability. If you smoke, you should attempt to stop for at least two weeks before liposuction.

The Day before the Liposuction Procedure
Be sure to properly prepare for liposuction surgery by packing loose and comfortable clothing, getting adequate sleep the night before, and arranging a ride home.

The Day of Liposuction Surgery
When you arrive for liposuction surgery, you will be asked to sign a consent form that ensures your understanding of the risks, benefits, possible outcomes, and all liposuction alternatives prior to the procedure.

Although the methods required to prepare for liposuction can vary doctor to doctor, your physician will likely draw on your skin to mark the areas to be treated, take a “before” picture to compare with your results after liposuction, and provide you with a dressing gown to change into before surgery.

If you are undergoing general anesthesia, you will be required not to eat or drink anything for at least six hours before surgery (this prevents you from developing an upset stomach while under anesthesia). For more details about the liposuction procedure, see our full section on liposuction surgery

Liposuction Alternatives

This is also known as “non surgical liposuction”. Some of the alternatives to liposuction are:

•Change diet to lose some excess body fat

•Exercise

•Diet

•Accept your body and appearance as it is

•Use clothing or makeup to downplay or emphasize body or facial features

•There are also natural liposuction alternatives. These include ways to
boost metabolism. Diet, exercise, yoga, breathing exercises, meditation, these particular liposuction alternatives relies on the body’s ability to rid itself of fatty tissue

•Some interesting alternatives also include seaweed wraps, and certain creams that claim to reduce the deposits of fat in certain body areas. However many of these products are not FDA approved and require more substantiated research

Liposuction Glossary

Anesthetic: drugs that cause the loss of feeling or sensation, often used to reduce pain

Canula: a hollow pen-like instrument/tube used to draw fluid and body fat

Emulsify: to break up into small pieces

Epinephrine: a drug injected before liposuction to reduce bleeding during the procedure

Lidocaine: an anesthetic that may be injected in large amounts of liquid during liposuction

Lipoplasty: another name for liposuction that relates to “plastic surgery”

Liposculpture: another name for liposuction. “Sculpture” captions to essence of the surgeon’s artform in “sculpting” the body

Liposuction: a usually cosmetic surgical procedure in which fat is removed from a specific area of the body, by means of suction and drawing out of bodily fluids and fat

Probe: another word for canula or a similar instrument that is used to probe out fat and bodily fluids

Sedative: a drug which helps a person to relax and may make them feel sleepy

Tummy Tuck: liposuction of the abdomen area

Thigh Lift: liposuction and contouring of the thigh (inner and outer) area

Ultrasound assisted liposuction: a type of liposuction in which fat is first loosened by using an ultrasonic probe and then removed by means of suction

My experience with Vaser Lipo

I just had Vaser Lipo in January of this year and I wanted to share my experience with anyone looking for info on liposuction.

I am 30 and in the best shape of my life, but no matter how much exercising I did, my “pear shape” just never went away. I have a tiny waist and giant butt. Vaser is what my doctor uses and he’s the expert, so I would’ve gone with whatever he recommended. In my own research, I was happy to see that the Vaser procedure had a faster recovery time and smoother results than traditional liposuction. And I would agree with what I read: my results were smooth and perfect and no one would be able to guess that I had any kind of liposuction.

I had Vaser liposelection on my inner and outer thighs. After the procedure I woke up and went home within 2 hours. I know I shouldn’t have, but that night I was in my basement playing pool!! I took one prescription pain pill for the pain and one Tylenol in the first week. That’s it! I was amazed that I needed so little help with the pain.

I don’t know exactly how much fat was removed, but I know it wasn’t much. I would guess less than two pounds worth. I was already skinny, I just carried my weight on my saddlebags. After I recovered from my lipo I found that I went from a size two pant with a big gap at the waist, to a better proportioned zero. Clothing shopping is so much more fun.

I am very happy with my results and am even more motivated than ever to stick to my exercise routine. I should have done it sooner! I am shocked at how many guys are hitting on me even though I wear a wedding band!

Liposuccion Paris Bordeaux Marseille Cannes Nice Hyères

Lipoplastie, lipoaspiration : traitement de la cellulite
Avant La lipoplastie Les résultats
Questions/réponses sur la liposuccion
Photos : avant et après
La liposuccion est l'intervention médicale la plus connue et la plus pratiquée aujourd'hui dans le monde.
La Lipoplastie ambulatoire sous Anesthésie Locale est une méthode de traitement radical et définitif de la cellulite et plus généralement de toutes les localisations de surcharges graisseuses.
Le lipoplasticien ne se contente pas simplement d'aspirer la graisse d'une façon radicale dans un secteur jugé trop volumineux.
Bien au contraire, grâce à l'utilisation de micro-canules extrêmement fines (toujours inférieures à 5 mm de diamètre donc des cicatrices invisibles) et la réalisation des plans croisés, il va redéfinir très précisément les courbes et le galbe d'une silhouette se rapprochant au plus près de vos désirs.

La technique des plans croisés

Il s'agit d'une très importante innovation introduite par le Docteur FOURNIER, l'un des principaux précurseurs de la lipoplastie en France et dans le monde.

Grâce à la création de plusieurs micro-incisions judicieusement disposées en périphérie de la zone devant être opérée, le praticien va pouvoir aspirer suivant un véritable réseau de petits tunnels entrecroisés.

Une fois cicatrisés, ces mini-tunnels auront disparu mais laisseront en place une sorte de toile de tissu conjonctif de soutien sous-cutané.
Ainsi on obtiendra un résultat parfaitement esthétique et très régulier.

Pas d'effet de vagues ou de toles nodulées

C'est pourquoi la lipoplastie permet d'éviter la survenue des désastreuses " vagues " ou " tôles ondulées " qui furent parfois constatées à la suite de lipoaspirations mal contrôlées par des mains inexpertes et l'utilisation de canules trop larges.

Pas d'hématomes ni de cicatrices disgracieuses gràce à la lipoplastie

De plus sans hématomes importants et par conséquent sans douleurs secondaires, la lipoplastie est également sans cicatrices disgracieuses grâce aux micro-incisions pratiquées.
Ces dernières sont en effet si discrètes qu'elles seront devenues très rapidement totalement invisibles.

L'intervention de liposuccion en elle-même

Vous devrez vous présenter à l'heure indiquée, soit à la clinique, soit directement au cabinet spécifiquement équipé du lipoplasticien.
En effet, pour pouvoir être admis, le praticien doit être en mesure de pouvoir offrir toutes les garanties requises de sécurité, de qualité et de fiabilité des installations qu'il mettra à la disposition de ses patients, pour la réalisation des actes spécifiques.

La liposuccion sous anesthésie locale

• Faites-vous bien préciser si vous devez être à jeun ou non.

• N'oubliez ni les résultats des examens, ni les traitements prescrits.

• N'oubliez pas non plus votre vêtement de contention.

• Prévoyez par prudence d'être raccompagné(e) à votre domicile après votre intervention.

• La durée de l'intervention dépendra du volume de la zone à aspirer.

Les suites opératoires d'une liposuccion

Elles sont très simples :

• Vous devrez porter votre gaine de contention pendant environ une semaine de façon permanente. Ensuite, seulement durant les périodes d'activité physique pendant 3 à 4 semaines.

• Si un point de suture ou une agrafe ont été posés, ils seront ôté selon les cas entre le 4ème et le 8ème jour.

• Vous ne ressentirez pas de douleurs véritables, mais seulement des courbatures, une gêne éventuellement un peu pénible les premiers jours, surtout lors des changements brusques de position.

• Selon votre état veineux habituel, il peut apparaître des ecchymoses plus ou moins importantes qui disparaîtront très rapidement en quelques jours.

• Cependant, il faudra éviter toute exposition solaire (ou aux rayons U.V.) tant que les ecchymoses resteront visibles.

• Les bains pourront être pris dès la cicatrisation des incisions.


Communiqué de presse sur la liposuccion

Villes en attente : Lyon, Toulouse, Nantes, Strasbourg, Rennes, Orléans, Le Havre, Brest, Lille, Reims, Saint-Etienne, Grenoble, Toulon, Angers.

Post-Tumescent Liposuction Care

Open Drainage and Bimodal Compression

The goals of postliposuction care must be to minimize edema, bruising and patient discomfort. The postoperative pain and edema resulting from sutured incisions and prolonged postliposuction compression is an irrational remnant from the days before the tumescent technique.
Antediluvian (before tumescent technique) liposuction resulted in such extensive blood loss that patients often had to donate and bank their own blood before surgery and receive an autotransfusion afterward. Prior to the advent of tumescent vasoconstriction, providing hemostasis and preventing hematomas or seromas were the primary goals of postliposuction external compression. Prolonged high-grade compression was thought necessary to prevent or diminish the size of hematomas and seromas. With the advent of the tumescent technique, and with its profound vasoconstriction and surgical hemostasis, imperatives of postliposuction care have changed. Some surgeons, however, are still unfamiliar with the technique of open-drainage and bimodal compression. The goal of postliposuction care is to optimize patient recovery, which in turn requires an objective comparison of available alternatives.
Liposuction Edema
Extracellular postliposuction edema occurs when there is excessive fluid postoperatively within the extracellular space. The two factors responsible for extracellular edema are impaired lymphatic drainage and excess capillary filtration. Lymphedema is distinctly different from venous capillary edema.[1] Treatments of these conditions are also distinctly different. If one's perverse goal is to produce the maximum degree of postliposuction edema, one must prevent the egress of subcutaneous fluid (1) by trapping the maximum amount of bloody fluid within the subcutaneous space and (2) by simultaneously blocking all lymphatic drainage. This goal can be achieved by closing incisions with sutures and then applying a high degree of external compression to collapse lymphatic capillaries.
In contrast, open drainage with bimodal compression minimizes postliposuction edema. Open drainage refers to an expedited drainage of blood-tinged anesthetic solution via incisions not closed by sutures. Bimodal compression refers to two sequentially applied degrees of postoperative compression. The first degree is a relatively high-grade compression that accelerates the drainage via open incisions. The second is a low-grade compression, employed after drainage has ceased, that is mild enough not to collapse the lymphatic capillaries, but adequate to increase interstitial hydrostatic pressure.
Lymphatic Drainage
The surgical effect of liposuction upon the lymphatics is unique in several respects. First, liposuction disrupts or destroys most lymphatic capillaries within the targeted adipose tissue. Second, lymphatic damage from liposuction is not permanent. Lymphatic capillaries regenerate within a few weeks after being torn by a liposuction cannula. In contrast, after surgical lymph node dissection, damage to lymphatics is permanent.
Damaged lymphatics are not able to transport excess interstitial fluid back to the blood. Lymphatic insufficiency can cause especially severe swelling and edema. The persistence of extravasated plasma proteins increases the interstitial fluid osmotic pressure and draws even more fluid out of the capillaries.
Excess Capillary Filtration
Excessive capillary filtration or fluid shift from the intravascular to the interstitial space is influenced by increased capillary permeability, decreased plasma colloid osmotic pressure, and increased capillary hydrostatic pressure. Decreased plasma colloid osmotic pressure occurs after liposuction because of loss of plasma protein through ruptured capillaries, consumption of hemostatic procoagulant proteins, and iatrogenic hemodilution with unnecessary IV fluid crystalloids, and possibly hemorrhage. Increased capillary hydrostatic pressure may occur after liposuction as a result of general anesthesia, secondary immobilization of limbs, and loss of sympathetic vascular tone.
Lymphedema
Lymphedema is edema caused by inadequate lymphatic function resulting from agenesis, destruction or obstruction of lymph vessels or lymph nodes. On a molecular level, lymphedema is the result of a failure of the lymphatics to remove large molecular proteins from the interstitial space. Although both hematic and lymphatic capillaries reabsorb interstitial water, the lymphatic capillaries are responsible for reabsorbing large proteinaceous molecules.
Although lymph capillary injury is an inevitable consequence of liposuction, the extent and duration of liposuction lymphedema can be significantly reduced by rational postoperative care. Early and aggressive efforts to expel as much blood-tinged anesthetic fluid as possible give immediate results. Once the drainage fluid is allowed to become trapped within interstitial microloculations, the edema becomes persistent and will only resolve once the injured lymphatic capillaries have been regenerated.
Normal Lymphatic Function
Proteins and other large molecules are too large to be absorbed into the blood directly across capillary membrane. Lymphatic capillaries have large gaps between adjacent endothelial cells that permit passage of large-molecular-weight substances. Lymphatic endothelial cell edges overlap each other slightly, forming minute unidirectional endothelial valves into the lumen of the lymphatic capillary. In addition, some lymphatic capillary endothelial cells overlap to a much greater degree than usual endothelial cell overlap and form internal bivalve flaps that act as one-way valves inside the lymphatic capillary. This valve structure inhibits retrograde lymph flow.
Microscopic Structure of Lymphatics
The wall of a terminal lymphatic capillary has an interior layer formed by a single thin endothelial cell and an external basal lamina that is widely fenestrated. In many places there are wide gaps between adjacent endothelial cells. These holes in the lymphatic capillaries facilitate the uptake of macromolecules, proteins, bacteria, blood cells, and tumor cells.[2]
Effects of Edema and Compression on Lymphatics
There is an important distinction between the effects of increased interstitial pressure owing to edematous fluid overload compared to the effects of compression on the external surface of the body, which elevates interstitial hydrostatic pressure.
In the first instance, the expansion of the swollen interstitial tissue causes the inside diameter of the lymphatic capillary to dilate. From the perspective of mathematical topology, edema causes every point within the tissue compartment to move further apart from every other point. This includes the lymphatic endothelial cells. The expanded lymphatic capillary inside diameter increases lymph flow, which tends to reduce the edema.
In the second instance, external compression squeezes the interstitial tissue and can compress the capillary lumen. This constriction limits the lymph flow and ultimately impairs the lymphatic capillary ability to reduce edema.
The Lymphatic Pump Mechanism
The rate of lymphatic flow is determined by the lymphatic pump mechanism and interstitial fluid pressure. The one-way lymphatic capillary valves allow a degree of lymphatic pumping when capillaries are compressed intermittently by an external force, such as by large muscles of a limb, movement of the body, arterial pulsations, and external massage. When larger lymphatic vessels become stretched with lymph fluid, the smooth muscle in the wall of the vessels contracts automatically and forces the lymph fluid through the proximal valve and into the next segment of the lymphatic vessel. This lymphatic pump mechanism generates the negative interstitial fluid pressure.
For the liposuction patient, excessive external pressure from compressive postoperative garments may be counterproductive. Continuous external compression, for example, from high-compression postoperative garments may cause the delicate lymphatic capillaries to collapse, impede lymph flow, and effectively block lymphatic drainage.
Lymph Flow and Interstitial Fluid Pressure
The normal interstitial fluid pressure is subatmospheric and ranges between -6 mm Hg to 0 mm Hg (atmospheric pressure). Experimental measurements in dogs show that the rate of lymph flow varies as a function of interstitial fluid pressure.[3] There is very little lymph flow below -6 mm Hg. Between -6 mm Hg and 0 mm Hg the rate of lymph flow increases exponentially until it reaches a maximum between 1 or 2 mm Hg. The rate of flow at 0 mm Hg is 20 times greater than at -6 mm Hg; however, when interstitial pressure exceeds 1 or 2 mm Hg, the lymph flow rate reaches a plateau. Lymph flow fails to increase with higher interstitial fluid pressures. One can conclude that a high compression postoperative garment is unlikely to increase the rate of lymph flow after liposuction.
Wound Fluid Osmolality
The clinical laboratory measurement of a serum osmolality requires that a serum sample be frozen as soon as possible after it is obtained. A long delay in freezing the sample exposes the serum proteins to temperature-dependent proteolysis. By effectively multiplying the number of solute particles in solution, proteolysis amplifies the osmolality of a sample. The trauma from tumescent liposuction allows plasma proteins to leak out of injured capillaries and into the subcutaneous wound space. Once a protein molecule has entered the subcutaneous wound space it can only re-enter the blood by way of lymphatic absorption.
Fresh wound fluid has an osmolality of approximately 10 mmol greater than serum. This osmotic pressure gradient will tend to draw water from intravascular space, across the capillary wall and into the wound space. Incubating residual blood-tinged tumescent fluid at body temperature increases the osmolality of fluid over time. This exacerbates postliposuction edema by an osmotic amplification by incubation.
Iatrogenic hemodilution by infusion of IV crystalloid fluids will increase intravascular hydrostatic pressure and therefore augment edema. External compression will counteract the effects of intravascular hydrostatic pressure but hinder the lymphatic uptake of would fluid containing protein molecules.
Antique Postliposuction Care
Liposuction causes a certain amount of subcutaneous bleeding as well as damage to the subcutaneous lymphatic capillaries. The combination of subcutaneous bleeding and impaired lymphatic drainage entraps large osmotically active molecules and produces an osmotic edema. Any technique for postliposuction care that contributes to this osmotic edema will increase the degree of postliposuction edema, pain, and bruising.
The traditional liposuction and postliposuction techniques often consort to produce an unnecessary degree of prolonged healing and edema. Incomplete tumescent infiltration will lead to subcutaneous bleeding, encourage a postoperative subcutaneous inflammation, and augment postoperative edema. The super-wet technique is an example of suboptimal tumescent liposuction. Sutured liposuction incisions prevent percutaneous drainage of residual blood-tinged anesthetic solution and encourage subcutaneous edema. Long-term use of a high-compression postliposuction elastic garment will compress and impair subcutaneous lymphatic capillaries and further block lymphatic uptake of large osmotically active molecules. There is a more efficient and effective method for postliposuction care.
An ideal method for postliposuction care prevents problems before they occur. Prolonged edema, excessive bruising, and persistent inflammation are the most bothersome and most common undesirable sequella of liposuction. To a large extent these problems can be avoided with a rational and scientific approach to postliposuction care. One successful method of postliposuction care uses open drainage, special super-absorbent pads that provide distributive compression, and bimodal compression.
Open Drainage and Compression Sponges
Open drainage after tumescent liposuction refers to the technique for maximizing the drainage of blood-tinged anesthetic solution by using adits (1.5 mm or 2 mm punch excisions for microcannula access to subcutaneous fat) to facilitate postoperative drainage, locating adits in strategic locations in order to encourage gravity-assisted drainage, and allowing the adits to remain open instead of being closed with sutures. Open drainage demands the use of comfortable, high-capacity absorptive pads, also known as compression sponges.
Compression sponges are a functional combination of absorptive sponges and compression pads. Absorptive sponges are required for the containment of the objectionable postoperative blood-tinged drainage. Containing the drainage avoids alarming the patient and prevents staining of clothing and furniture. Complete absorption and containment of the drainage allows the patient to mobile and sociable. The copious drainage that occurs after tumescent liposuction demands absorptive pads with a special design.
Compression pads are postoperative cushions place over liposuctioned areas in order to distribute the compression provided by an elastic compression garment in a smooth and uniform manner. Uniform, gentle compression of subcutaneous tissue after liposuction collapses the gaps within the interstitial collagen of the dermis. Therefore, dermal compression prevents bruising by blocking the outward percolation of red blood cells up toward the epidermis.
An effective and practical way of applying the compression-absorption pads over the targeted areas is to use a combination of a few strips of paper tape and elastic tube netting, similar to the method of applying dressings over burn wounds. After the compression-absorption pads are well positioned, one can apply the elastic compression garment. The optimal garment in this regard must be able to accommodate the bulk of the pads, and the pads must be easy for the patient to take off and put on again without assistance.
Bimodal compression refers to the sequential use of two different degrees of postliposuction compression. First, a high degree of compression is maintained while drainage persists and for an additional 24 hours past the time when all the drainage has ceased. Twenty-four hours after all drainage has ceased only a relatively mild degree of compression is required.
In the Old Days Sutures were Necessary
In the days of antediluvian liposuction, surgeons were compelled to close liposuction incisions with sutures. Before the tumescent technique and microcannulas, liposuction cannulas were large and required large incisions, which required sutures for proper healing. With the modern tumescent technique (including the use of microcannulas and adits), postliposuction healing is better when incisions are not closed with sutures.
In the past, using sutures to close an incision was seen as necessary to prevent infections. In fact, with the advent of nearly bloodless tumescent liposuction, many of the problems that necessitated the closure of liposuction incisions with sutures no longer exist. Without tumescent vasoconstriction there was a relatively high incidence of hematomas and seromas. Hematomas and seromas provide an avascular medium for bacterial growth and infection. An open incision had the potential for being a port of entry for an infection.
With the tumescent technique, hematomas are rare, and the incidence of seromas is virtually eliminated by open drainage and good compression. Tumescent lidocaine further reduces the risks of infection, because residual interstitial lidocaine is bacteriocidal in the sense that it appears to prevent infections after tumescent liposuction. Therefore, the tumescent technique appears to have reduced the risk factors for infection, and open drainage probably reduces the risk of infection even further.
Adits
An adit is a technical engineering term that describes a horizontal opening by which a mine is entered or drained. A micro-adit used in tumescent liposuction is a small circular hole made by a tiny (1.5 mm or 2 mm) skin biopsy punch. Adits facilitate and promote the open drainage of residual blood-tinged anesthetic solution associated with tumescent liposuction.
It is common knowledge that 1.5-mm and 2-mm skin biopsy punches leave virtually no scars. Therefore, 1.5-mm or 2-mm punch excisions can be placed over a liposuction area with minimal risk of scarring. Adits are especially helpful areas, such as the thighs and the abdomen, where postoperative edema and bruising can be more pronounced and bothersome than in other areas.
A 16- or 14-gauge microcannula can easily pass through a 1.5 mm adit. These size microcannulas can enter through a 1.5-mm round hole with virtually no epidermal friction as the microcannula is pushed and pulled through the skin. A 12-gauge microcannula often requires a 2-mm adit. With a careful and skilled liposuction technique, especially in areas of the skin such as the inner thigh, a 1.5-mm adit can often accommodate a 12-gauge microcannula with minimal epidermal trauma.
For the outer thigh the best site for an adit is the most dependent margin of the targeted area. Insert a 16- or 14-gauge microcannula through the tiny hole and create multiple liposuction tunnels in order to funnel the postoperative drainage to the adit opening.
The most important advantage to using round adits is that round holes remain patent for a longer time than a slit incision. Round 1.5-mm and 2-mm adits allow better drainage than simple incisions. The edges of a microincision may close and heal before the blood-tinged anesthetic has been completely drained, therefore entrapping blood-tinged anesthetic solution in the subcutaneous space.
Several 2-mm punch excisions placed along the lower margin of the abdomen, above the pubic area, allow more drainage than tiny slit incisions. Adits placed along the lower abdomen plus firm, uniform compression will virtually eliminate postliposuction ecchymosis and seromas and dramatically reduce postoperative swelling and tenderness.
Even with the use of a large cannula and the closure of incisions with sutures, the judicious use of adits can provide all the advantages of open drainage. The strategic use of surgical adits significantly improves the rate of recovery by decreasing the duration of postoperative bruising, swelling, tenderness, and significantly reduces the incidence of seromas and hematomas.
Eliminating Sutures
The most significant advantage of placing adits or eliminating sutures is the dramatic acceleration of recovery and reduction of postliposuction edema. There is a striking contrast between closing incisions with sutures compared to allowing the adits or incisions to remain open. Sutures do not benefit from a 4-mm microincision. Some surgeons close incisions with sutures because of a concern that the profuse drainage will alarm the patient and necessitate increased nursing care[4]; however, with super-absorptive compression sponges, there is no longer any need for concerns about messy postliposuction drainage.
The advantages of not using sutures include (1) more complete drainage, leading to less edema, less tenderness, and less ecchymosis; (2) adits and microincisions (5 mm) heal better without sutures because there is no suture-induced inflammation, no foreign-body reactions, and no cross-hatch scars; (3) patients need not return for suture removal, therefore saving the patient time and avoiding inconvenience. Patients become less apprehensive about the disconcerting appearance of blood-tinged drainage once it has been explained that the greater the drainage the less the postliposuction bruising, swelling, and soreness.
Compression Sponges
Compression sponges or pads have two distinct functions. They completely absorb the copious tumescent drainage and therefore improve patient comfort and hygiene. Containing SAP and cellulose, a 25 cm x 50 cm (10 inch x 20 inch) compression sponge can absorb up to 1,000 mL of watery fluids. Secondly, these compression sponges or pads distribute the compressive force of an elastic garment over the treated area in a smooth, uniform fashion. By uniformly compressing the dermal interstitial collagen, the interstices between the dermal collagen bundles are narrowed and red blood cells are prevented from moving toward the skin surface. Therefore, bruising is prevented.
Super-absorbent compression sponges eliminate postoperative bruising in a fashion similar to adhesive-backed, closed-cell foam when applied postoperatively over an area of the body that has been treated by liposuction. Compression pads are superior to adhesive closed-cell foam for postliposuction care. Adhesive foam applied to the skin after liposuction can crimp and cut off dermal vascular dermal supply, and therefore cause focal avascular dermal bullae. Adhesive foam must remain on the skin for several days, which precludes the possibility of showering. In contrast, the compression sponges are replaced once or twice daily, permitting patients to shower. Whereas adhesive foam only reduces bruising, super-absorbent compression pads both reduce bruising by compression and reduce osmotic edema by facilitating open drainage.
History of Postliposuction Compression
The tradition of long-term use of high-compression garments after liposuction is a vestige of the earliest days of liposuction during the late 1970s and early 1980s. In the days before the tumescent technique, antediluvian liposuction created a proteinaceous melange of grumous clotted blood, inflammatory cytokines, prostoglandins, and fragmented adipose tissue. By closing incisions with sutures, this inflammatory detritus was trapped within the subcutaneous wound. The patient was required to endure weeks of being wrapped in special plastic adhesive "French" tape in the manner of a mummy. Taking a normal shower or bath was not an option. Removing the tape could be so dreadful that some patients required systemic narcotic analgesia. Eventually surgeons replaced the use of "French tape" with high-compression elastic postoperative garments. With either type of compression, there was a high rate of seroma formation, massive bruising, prolonged swelling and tenderness, and significantly delayed return to normal activity.
Chronic venous edema and acute postliposuction edema are distinctly different pathophysiologic processes. Leg edema owing to venous disease is best treated and prevented by providing graduated leg compression beginning at 15 mm Hg to more than 30 mm Hg distally, and decreasing proximally. In contrast, local edema owing to tumescent liposuction can be largely prevented by open drainage and uniform (non-graduated) bimodal compression. It is a misconception that the pathophysiology of acute postliposuction leg edema resembles chronic post-phlebitic venous disease. Chronic venous insufficiency is due to venous hypertension and a hydrostatic pressure gradient that favors chronic leakage of intravascular fluid into the interstitial tissues. Acute postliposuction edema is due to acute posttraumatic hemorrhage, inflammation, and an osmotic pressure gradient.
Excessive Compression
Prolonged high compression is only necessary when drainage is impeded by closing incisions with sutures. With old-fashioned liposuction, the subcutaneous voids and tunnels were filled with blood, clot, or hematoma. Constant compression applied externally to the skin has the tendency to squeeze the delicate subcutaneous lymphatic capillary, causing the lumen to collapse upon itself and preventing interstitial fluid from entering the lymphatic capillary lumen. Therefore, excessive continuous external compression may actually impede lymphatic drainage and exacerbate postoperative edema. Without open drainage, the compression delivered by traditional postliposuction garments may be detrimental.
Graduated Verses Bimodal Compression
Therapeutic compression after liposuction is qualitatively different from the type of compression used to treat leg vein disease. Varicose vein treatment requires compression to overcome venous hypertension, and prevention of perioperative deep vein thrombosis requires compression to prevent the venostasis associated with the general anesthesia-induced loss of sympathetic vascular tone. In contrast, compression after tumescent liposuction is intended to expel the subcutaneous fluid containing a melange of blood, fragmented adipocytes, and trauma-induced inflammatory exudates.
Lower extremity venous stasis is treated by a graduated compression garment. Graduated compression is necessary to counter the hydrostatic (gravitational) forces within veins having incompetent valves.[5] Because the hydrostatic force exerted by a vertical column of fluid increases as a function of the column's length, venous pressure in leg veins with incompetent valves increases distally when the patient is in an upright posture. In this setting, graduated compression is necessary to counteract the progressive increase in physical forces exerted by fluid contained within the "closed" hydraulic system of the lower extremity.
Graduated compression is not necessary after tumescent liposuction. Open drainage and bimodal compression are more efficient and more comfortable, and the compression garments are easier to put on and take off compared to graduated compression garments.
Optimal Compression is Bimodal
Proper postoperative compression after tumescent liposuction requires two degrees of compression applied sequentially (i.e., the compression after tumescent liposuction is bimodal). Bimodal compression involves two distinct therapeutic phases: the drainage phase and the post-drainage phase.
During the drainage phase, high compression is applied immediately after liposuction to encourage drainage from adits and open microincisions. Uniform high compression will maximize the drainage out of the suctioned subcutaneous adipose tissue onto the absorptive dressings and minimize postliposuction edema. With open drainage and high compression, the tumescent drainage usually ceases in 24 to 72 hours. After liposuction of an unusually large abdomen or thighs, drainage may persist for several additional days. Once all the drainage has ceased, external compression is no longer essential. The ultimate cosmetic result does not depend on continued compression after all tumescent drainage has ceased.
During the post-drainage phase, after all the drainage of blood-tinged anesthetic solution has ceased, only a mild degree of compression is needed. Once external drainage has ceased, lymphatic uptake is the only means of clearing the subcutaneous tissue of protein-laden edema fluid. The function of mild compression is to augment the interstitial fluid hydrostatic pressure just enough to counterbalance the increased interstitial fluid osmotic pressure, and thereby slow the rate of transudation of intravascular water. Mild compression also provides a sense of security during physical activity and seems to provide a moderate degree of analgesia and comfort.

The Two Standards of Care for Tumescent Liposuction

There are two standards of care for tumescent liposuction: true tumescent liposuction, which is totally by local anesthesia, and semi-tumescent liposuction, which requires general anesthesia or heavy IV sedation. Both techniques can be done safely. However, there is a greater risk and a definite tendency for a surgeon to exceed the limits of safety when using semi-tumescent liposuction. There have been no deaths associated with true tumescent liposuction.
The tumescent technique was developed to minimize surgical risk and optimize patient comfort. When a surgeon intentionally modifies the tumescent technique and increases the risks of surgical complications, then the technique cannot accurately be termed the true tumescent technique or true tumescent liposuction.
When liposuction by general anesthesia (IV or inhalational), and a modified tumescent technique results in a patient's death from the effects of excessive volumes of fat removal, excessive IV fluids, hypothermia, or complications of general anesthesia such as anoxia, pulmonary embolus, or asystole, is it accurate to state that the death was associated with associated with tumescent liposuction?
Consider the following vignette. A group of specialists starts using a safe surgical technique not invented by them; then they modify the technique, making it more dangerous; then they experience serious complications and fatal outcomes; then they claim only they have the training and experience to perform such a dangerous procedure.
In order to assure the public that not all tumescence techniques are created equal, and to avoid confusion over terminology, the following definitions must be articulated. Because the tumescent technique for liposuction has evolved and greatly improved over the years, prior terminology is now antiquated and inaccurate. The following definitions are intended to provide some precision to one's tumescent vocabulary.
The Tumescent Technique is a pharmacologic method of drug delivery that produces wide spread local, regional, or systemic effects by subcutaneous infiltration of very dilute solutions of the drug in physiologic saline or a similar solution. Any type of drug that can be injected subcutaneously is a potential candidate for
delivery by the tumescent technique.
Tumescent Hemostasis is achieved using the tumescent technique to produce widespread, profound, and prolonged vasoconstriction in subcutaneous fat by the infiltration of very dilute epinephrine, for example 1:1,000,000,(that is 1 g epinephrine per 1,000,000 mL of normal saline or Ringer's lactate, which is equivalent to 1 mg/1,000 mL).
Tumescent Anesthesia is a technique for local anesthesia. It uses large volumes of dilute lidocaine and dilute epinephrine to permit liposuction totally by local anesthesia without general anesthesia, or IV sedation, and with virtually no significant blood loss. The actual formulation of the tumescent anesthetic solution varies as a function of clinical requirements. Typically the concentration of lidocaine varies between 500 and 1,500 mg/L, while epinephrine may vary between 0.5 and 1.5 mg/L.
True Tumescent Liposuction is a very specific method of doing liposuction totally and exclusively by local anesthesia. Tumescent liposuction incorporates tumescent anesthesia (dilute lidocaine and epinephrine) with the use of micro-cannulas, and small incisions that are not closed with sutures. Incisions that are not closed with sutures promote copious postoperative drainage, which in turn reduces systemic lidocaine absorption and dramatically reduces postoperative inflammation as well as bruising, soreness, tenderness, and swelling. To the best of my knowledge there have been no deaths associated with tumescent liposuction totally by local anesthesia without parenteral narcotic analgesia or general anesthesia.
Semi-tumescent Liposuction, or semi-tumescent technique, is the liposuction by general anesthesia (IV or inhalational) or heavy IV sedation. It is a forme fruste, on an incomplete version of tumescent liposuction. Semi-tumescent liposuction implies that the tumescent technique is used only for its ability to produce profound hemostasis, and postoperative anesthesia. Semi-tumescent liposuction has increased risks including the toxicity and dangerous side effects of general anesthesia. Semi-tumescent liposuction ignores the improved safety provided by local anesthesia compared with the risks associated with general anesthesia. Every death reported in association with liposuction has also been associated with general anesthesia, heavy IV sedation, or bupivacaine.
Meretricious (1)- Tumescent Liposuction is identical to the outmoded wet technique, with the exception that the patient has been falsely promised that the tumescent technique will be used. Unfortunately such deception is not uncommon. Having been educated by the media, most prospective patients demand the safety of the tumescent technique. It is meretricious to promise the tumescent technique of the surgeon has never performed or does not intend to perform liposuction totally by local anesthesia.
Licentious (2)- Tumescent Liposuction is dangerous liposuction associated with any one of the following: liposuction of an excessive volume of fat, excessive number of areas treated, excessive IV fluids infused, excessive blood loss, excessive quantities of local anesthetics, and the complications of general anesthesia. Licentious liposuction is dangerous liposuction that goes far beyond the limits of safety as defined by the empiric rules of normal human physiology.
Before the tumescent technique, the safe maximum volume of liposuction was limited by surgical blood loss. With the advent of tumescent vasoconstriction, safety limits for liposuction still exist, but they are now less obvious. Tumescent hemostasis seduces surgeons into a false sense of security. With liposuction totally by local anesthesia, an alert comfortable patient can communicate, and warn the surgeon about the onset of symptoms of excessive surgery such as hypothermia, hypo tension, or pulmonary congestion. However, with tumescent hemostasis surgeons see no blood loss, and with general anesthesia or heavy IV sedation they are more likely to miss early signs of impending shock. In this sense, general anesthesia predisposes to excessive liposuction and requires extra caution.
Licentious liposuction occurs most frequently in association with general anesthesia because Brobdingnagian volumes of fat are liposuctioned more easily general anesthesia. Consequently, the risk of an iatrogenic death is significantly greater with liposuction by general anesthesia or heavy IV sedation.
When tumescent liposuction crosses beyond the pale and into the domain of excessive surgical trauma, it metamorphoses from a benign cosmetic procedure into a malignant process. A cavalier surgical attitude, a naive sense of security, an avaricious motivation, or a foolish desire to satisfy a patient's request to "do it all in one surgery" are dangerous ingredients; add general anesthesia to the recipe and the result is a prescription for disaster. There is no antidote for this poisonous combination. The only safe approach is prevention, which requires a knowledge of modern pharmacology and physiology, a careful surgical technique, and prudent limits to the amount and extent of surgery. Above all do no harm.
Ultimately, not even board certification significantly reduces the risk of death from liposuction. The only factor that significantly affects the safety of liposuction is the type of anesthesia that is used. The tumescent technique for liposuction totally by local anesthesia is safer than the semi-tumescent technique that uses general anesthesia or heavy IV sedation.

LipoSelection®

VASER® liposuction emulsifies fat prior to removal, facilitating the liposuction process and reducing pain and tissue damage. LipoSelection® uses an ultrasound probe to break up fat before it is removed. This type of liposuction reduces pain and results in a faster healing time.

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The Vaser® Liposuction Procedure
LipoSelection®, developed by VASER®, is an ultrasonic (UAL) liposuction procedure, meaning it uses ultrasonic energy as a means of fat removal. The ultrasound technology breaks up and emulsifies the fat that is to be removed. Unlike other fat removal methods, LipoSelection® leaves the surrounding nerves, blood vessels, and tissue virtually unharmed. After a local anesthetic is applied, the surgeon will fill the area to be treated with a saline wetting solution to numb the site and shrink blood vessels. This helps minimize post-surgical bruising and swelling. A small probe emitting high frequency sound energy is used to break up fat on contact with minimal damage to surrounding tissues. Fat may then be easily extracted with liposuction tubes.

What Areas of the Body Can LipoSelection® Treat?
The level of precision and safety LipoSelection® provides allows physicians to sculpt and shape delicate areas of the body, such as the arms, chin, neck, and inner thighs. VASER® liposuction can remove fat from any area treatable with traditional liposuction techniques: abdomen, thighs, buttocks, knees, hips, back, arms, male breasts, love handles, chin, and neck areas. Because LipoSelection® does not harm the tissues surrounding the treated area, patients experience only minimal bruising.

LipoSelection® Benefits – Improved Body Contour, Minimized Pain
This proprietary method by VASER® is considered an advanced liposuction method in terms of both precision and diminished pain for the patient. LipoSelection® uses ultrasound technology to emulsify fat prior to removal. The liquefied fat can then be removed with ease, leaving surrounding tissue relatively undamaged. Not only will you experience less bruising and swelling following surgery, LipoSelection® is less painful than traditional liposuction. This is because the sensitive nerves, blood vessels, and connective tissue beneath your skin will remain largely undisturbed during the procedure.

LipoSelection® Risks
The risks of VASER® liposuction are very similar to the liposuction risks associated with any other method. However, because LipoSelection® minimizes damage to other body tissues, patients typically experience less pain and fewer side effects than with other forms of liposuction. Serious liposuction complications are quite rare. Fat clots or blood clots may form, and there is a chance these will migrate to the lungs and cause serious illness. The fluid loss that results from liposuction will be anticipated by a qualified doctor, as it can cause low blood pressure, friction burns, or fluid buildup. The LipoSelection® probe’s ultrasound energy may injure the skin or deeper tissues, although in most cases the benefits of the ultrasound system make it safer than traditional liposuction. If a doctor inexperienced with the LipoSelection® procedure applies too much fluid, the wetting solution may collect in the lungs. If there is too much lidocaine in the liposuction solution, lidocaine toxicity may develop.

Power Assisted Liposuction

Because it can be difficult to move a cannula – the liposuction tube used to remove fat – back and forth through fat tissue, surgeons are not always able to effectively remove all unwanted fat. PAL, or power assisted liposuction, features devices that are easier for surgeons to control, allowing for more precise and thorough fat removal. These devices produce rapid, small vibrations to break up fat so that it can easily be suctioned out through the cannula.

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The Power Assisted Liposuction Procedure
Power assisted liposuction is performed using a special cannula which uses tiny, rapid vibrations to break up fat cells so that they can be suctioned out of the body. Doctors can remove more fat in a shorter period of time, which leads to enhanced results, a safer procedure, and faster recovery. PAL is performed using the tumescent liposuction technique, in which an anesthetic liquid is injected into the treatment area for smooth fat transfer through the cannula and out of the body.

Vibrating Cannula
In PAL ( power assisted liposuction), the tip of the cannula, the tube used to extract fat from the body, vibrates rapidly. This vibration actually makes liposuction gentler on the body’s tissues because it loosens fat cells and allows them to be easily suctioned away. This specialized cannula allows for smaller incisions and reduced recovery time compared with other liposuction techniques. The vibrating tip used in PAL allows for safer liposuction because of its small, precise motions. Surgeons can target specific areas without damaging surrounding tissue.

PAL Benefits – The Gentle Form of Liposuction
Doctors do not need to use as much force during a power assisted liposuction because the vibrating cannula helps release fat cells from the body. In a study led by the Department of Dermatology at Tulane University Health Sciences Center, researchers found that 30 percent more fat was removed with PAL than with manual liposuction, while bruising and recovery time were significantly reduced. This makes PAL useful for treating areas that are notoriously difficult to sculpt, including the inner thighs, belly button area, and male breasts. Because the power assisted liposuction procedure takes less time to perform than manual liposuction, patients are less susceptible to complications and safety risks. Patients report many long-term benefits of fat removal with liposuction.

Power Assisted Liposuction Risks
As with all surgical procedures, there are some risks associated with power assisted liposuction; however, patients can reduce these risks by selecting an experienced power assisted liposuction surgeon to perform their procedure. Liposuction can leave skin loose, uneven, and wrinkled, though it may tighten over time. Some patients also experience pigmentation following surgery. If leftover fluid collects in the lungs from a tumescent liposuction, serious illness can develop. Tumescent liposuction solution with excessively high lidocaine content may cause lidocaine toxicity.

Find a Power Assisted Liposuction Surgeon in Your Area
PAL, or power assisted liposuction, allows patients to achieve dramatic results with the enhanced safety of precision surgery. For the best results with minimal risk to your health, use DocShop to find a qualified power assisted liposuction surgeon in your area.

Liposuction

Liposuction
Often used in conjunction with other plastic surgery techniques, liposuction removes pockets of fat from troublesome areas such as the thighs, hips, abdomen, and upper arms. Liposuction procedures vary depending on what your ultimate cosmetic goal is, and whether you are combining liposuction with other plastic surgery procedures. To learn more about liposuction, read the sections below.

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What Is Liposuction?
Many Americans have only a vague concept of what liposuction is. Simply put, liposuction is the surgical removal of fat cells through a stainless steel suction tube called a cannula. Liposuction was first performed in 1974 and was a tremendous improvement over previous surgical body contouring techniques. There have been many advances in liposuction procedures over the last few decades, making it one of the safest and most popular body contouring surgeries in the world.

Are You a Good Candidate for Liposuction?
If you are considering liposuction, it is important that you have realistic expectations. Although dramatic results can be achieved, they may not be as immediate or obvious as you would like. As with all plastic surgery, the success of liposuction will depend on a number of individual factors, such as age, skin elasticity, weight, and overall health. Liposuction is not appropriate for people with a weakened immune system, diabetes, heart or artery problems, or a history of blood clots or restricted blood flow. You are a good candidate for liposuction if you are of normal weight; have healthy, elastic skin; and have specific “trouble areas” such as the tummy, thighs, and butt that will not respond to changes in diet and exercise. Liposuction is also appropriate for women who are considering breast reduction, and for men who suffer from gynecomastia, or male breast development. To learn more, see our full page on liposuction candidacy.

How to Choose a Liposuction Surgeon
Before choosing a liposuction surgeon, you should learn as much as you can about the different practitioners in your area. You will want to ask lots of questions, view before and after photos of previous patients, and find out how many liposuction procedures the surgeon has performed in the past. Watch out for hard sells and overblown claims; a good surgeon should rely on his or her skill rather than exaggerated promises. For more detailed information, see our guide to choosing a liposuction surgeon.

Areas of the Face and Body Treatable with Liposuction
Liposuction works best for areas of the face and body with stubborn fat deposits resistant to overall weight loss, such as the infamous “love handles.” The thighs, abdomen, buttocks, flanks, hips, upper arms, chin, jowels, and neck generally respond well. Men and women may also choose liposuction to reduce breast size, a procedure that results in less scarring than other types of plastic surgery. Liposuction can be performed consecutively on many different sites; in fact, many patients choose to have several body parts treated during the same day. Learn more about facial liposuction and liposuction of the body.

Types of Liposuction
There are several types of liposuction procedures available, all of which use a wand-like instrument called a cannula to remove unwanted fat. Tumescent liposuction involves the injection if a large amount of anesthetic into the area being treated; the wet and super-wet techniques are variations of this type of liposuction. In ultrasonic assisted liposuction (UAL), sound waves are used to liquefy the fat before it is removed. LipoSelection® uses the same concept without disturbing the surrounding tissue. Power assisted liposuction (PAL) employs a motor-powered cannula, which allows the surgeon to use smaller movements and make the experience more comfortable for the patient.

Liposuction Cost and Financing Information
The cost of liposuction can vary greatly depending on the type you chose, the area(s) of the body you want to target, and your surgeon. Generally, liposuction procedures run anywhere from $1,500 to $7,500, your total cost depending on the number of treatments you undergo. Except in very rare cases, liposuction is not covered by insurance, and must be paid in full by the patient. There are many financing options available for plastic surgery through national credit companies such as CareCredit®, Capital One® Healthcare Finance, or Unicorn® Financial. For more information, see our section on liposuction financing and liposuction costs.

The Liposuction Procedure
The basic liposuction procedure involves the insertion of a small, tube-like instrument called a cannula through tiny incisions made by the surgeon. The cannula then breaks up and vacuums away unwanted fat deposits beneath the skin. Local or IV sedation will be used, depending on the type and number of liposuction procedures you undergo. As with any plastic surgery, you should prepare for liposuction carefully and allow yourself plenty of recovery time.

Risks and Benefits of Liposuction
Like any plastic surgery, liposuction carries some amount of risk. Although liposuction complications are rare, they can include infection, nerve damage, seizures, and negative reactions to anesthesia. The most effective way to minimize your risk is to have a thorough physical examination prior to liposuction surgery. There is also the risk of experiencing adverse side effects, such as bruising and scarring. On the other hand, the benefits of fat and cellulite removal can be enormous, with many patients reporting improved appearance, self-esteem, and overall confidence.

Maintaining Your Figure after Liposuction
Although liposuction does remove a number of existing fat cells, it does not guarantee that you won’t regain some fat. The importance of healthy lifestyle choices post- liposuction cannot be stressed enough; you should stick to a moderate diet and be sure to exercise for at least 30 minutes three to five times per week. Not only will this help you maintain your figure after liposuction, it will also improve your overall health and help prevent the onset of certain diseases. If you are going to treat yourself to liposuction, be sure to treat your body well afterward! For more post- liposuction tips, see our full section on diet and exercise after liposuction.

Liposuction FAQs
Although there is a wealth of information about liposuction procedures on TV, in magazines, and on the internet, you probably still have a lot of questions. One of the best sources of information you will find is a well-trained physician, but before you schedule an appointment, you might want to familiarize yourself with some of the commonly asked questions about liposuction. This will help you pinpoint any questions you still have about plastic surgery and liposuction before you consult with a doctor.

Find a Liposuction Surgeon in Your Area
To learn more about the various liposuction procedures available, contact a qualified plastic surgery specialist for a liposuction consultation. DocShop can help you locate a skilled liposuction surgeon who can give you a cost estimate and answer all of your questions.