Liposuction is a very common and popular procedure for removal of fatty (adipose) tissue in isolated areas that do not respond to diet and exercise.
These areas include the hips, thighs, abdomen, knees, ankles, face, neck and upper arms. Liposuction is most successful in people with good skin tone who have isolated fatty deposits. It is not a treatment for obesity. Body contours made irregular by fat can be improved by this procedure; it cannot correct contours that are irregular for other reasons, such as muscle weakness or poor tissue tone.
However, combined with other procedures such as abdominoplasty, liposuction can correct these other deformities with good results. The procedure can be repeated, if necessary. To maintain the safety of the procedure, there is a limit on how much can be done at one time. Dr. Wigod does not perform high volume liposuction.
Liposuction has potential to be used inappropriately in patients who want to minimize scars and avoid excisional body contouring surgery such as abdominoplasty. Liposuction in patients who would really be best treated by more extensive surgery may result in sub-optimal or even very poor results. Some cosmetic surgeons who are not Certified by the American Board of Plastic Surgery are not trained to perform more extensive surgery and therefore may not offer it as an alternative. As a fully trained surgeon, Dr. Wigod is able to perform all the surgical options and can therefore counsel you to make the most appropriate choice for an optimal outcome.
Liposuction is done under general anesthesia as an outpatient or an inpatient if combined with other procedures. The surgeon makes small (less than 1/2 inch), discreet incisions in the areas to be treated. A saltwater (saline) solution mixed with local anesthetic to decrease pain and epinephrine to decrease bleeding is then injected. This is called tumescent technique and is commonly used be most surgeons. A cannula (long, thin, hollow tube) attached to a suction machine is inserted through these small incisions. The cannula is then moved through the adipose tissue to be removed repeatedly in an even and methodical manner. The procedure may take an hour or more, depending on how many areas are involved.
There are several different methods surgeons may use when performing liposuction, including suction-assisted lipectomy (SAL), ultrasound-assisted lipectomy (UAL), power-assisted lipectomy (PAL), and laser-assisted lipectomy (e.g. Smart lipo). Each technique has its appropriate application and may yield good results when used by a well trained Plastic Surgeon. Dr. Wigod prefers using traditional liposuction, SAL. Because it is completely dependent on the surgeonโs movement, SAL feels to him more like using chisel to sculpt a statue as opposed to using a large chain saw or a small paring knife. When considering reliability, safety, and value, Dr. Wigod believes traditional liposuction still gives the best results in his patients. He is always open to using new techniques when they serve the interests of his patients better than his current methods.
Recovery from liposuction is relatively easy. Expect swelling and bruising in the following weeks, but activity is only limited by pain. You will wear special garments to apply pressure, minimize swelling and provide support while healing. These garments also assist in retraction of the skin. Stitches will be removed in a week. Avoid sweating and the sun until all bruising has subsided. A sunscreen should be used routinely; it is easy to get sunburned during recovery because of decreased sensation.
Results may be recognizable almost immediately, but will continue to improve as swelling subsides. Do not expect a final result until months after your operation. The results of liposuction are not permanent. If you were to gain a large amount of weight, you may regain weight in a previously treated area.
Cosmetic complications include contour irregularities, skin discoloration, asymmetry, scar tissue, tape burns, collection of blood or fluid under the skin and may be unavoidable. More uncommon complications include loss of sensation, skin breakdown, fat embolism, serious infection or shock.
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