WHAT IS LIPOSUCTION?

For the most part, you feel good about many aspects of your body's appearance, but perhaps there are one or two “issues” that you would love to see smoothed, flattened or reduced. Often, these "issues" are due to genetics, and are not something that we can control. The way our bodies store and deposit fat is programmed by our genes. Some of us hold fat around our middle, or abdomen, and some around our bottom, hips and thighs. However, how your body stores fat can be altered. Current theories about fat cells state that there are a certain number of fat cells in a given area that can develop throughout childhood, but that after puberty, the number of cells generally does not increase. If weight is gained, the amount of fat stored in a given cell can increase, but the number of cells will not. This concept explains why removing fat (and fat cells) with liposuction can be permanent. When liposuction is done, the number of cells in the given area is reduced. If future weight gain occurs, more fat can be stored in the treated area, but the shape that was achieved will be maintained. For example, if a "saddle bag" on the lower outer thigh is removed with liposuction, but after surgery the patient gains a significant amount of weight, the thigh overall will become larger, but the "saddle bag" will remain flat.

Liposuction (also known as body contouring or liposculpture) is the single most common cosmetic surgery in the United States, with more than 400,000 procedures done in the U.S. alone. You have likely heard about liposuction hundreds of times, but perhaps you do not know exactly what it involves. Come into our office and we will take the time to educate you completely, and formulate a personal treatment plan to help you make the best possible decision. In basic terms, liposuction is a cosmetic surgery procedure in which the fat in a particular area of the body is broken up and then “sucked” from the body. The fat is removed via a cannula, which is a tiny hollow tube attached to a high-pressure vacuum.

Dr. Rice is an experienced liposuction surgeon, having done hundreds of body contouring procedures in his career. In addition to body contouring with liposuction, he uses liposuction on all of his facelift patients to ensure the best possible outcome and form for the neck and jowls of the face. He enjoys the artistic aspect that body contouring/liposculpture entails, and he takes pride in the finesse that is required in such a procedure.

WHO IS A LIPOSUCTION CANDIDATE?

Let us begin with what liposuction is not. Liposuction is not a cure for obesity, nor is it a weight loss method. The goal of liposuction is aesthetic—although megaliposuction (an experimental procedure done in a hospital setting) has been shown to improve one's health or BMI level, liposuction it is not performed with this in mind. Furthermore, liposuction does not remove cellulite, or stretch marks. The liposuction procedure is designed for individuals who have a relatively stable body weight, but have specific areas of the body from which they would like to remove fat deposits to improve their overall shape. Liposuction is about shape changing; it works beautifully to bring back the "hour glass" shape that we lose due to life, aging or child birth. It can remove stubborn collections under the chin, at the bra line, or that cause the "muffin top" that we despise, and it can permanently slim thighs and/or eliminate "cankles" (when fat volume of the calf extends into the ankle).

With this premise in mind, if you are in relatively good physical shape and have fat deposits that have been unresponsive to diet and exercise, you may find liposuction is right for you. Liposuction can be done anywhere that there is a collection of fat on the body, however it most commonly targets the following areas:

Abdomen
Back
Breasts (Male or Female)
Buttocks
Chest
Inner knees
Hips
Flanks (love handles)
Neckline
Thighs (outer and/or inner thighs)
Upper arms
Calf/ankles

Additionally, good liposuction candidates will have good skin elasticity and be in good health.

WHAT DOES THE PROCEDURE ENTAIL?

Liposuction procedures typically last between one to four hours, depending upon the size of the patient and the number of areas to be addressed. The first step is the surgical plan. Just before the procedure, Dr. Rice will draw concentric circles and shapes around the areas to be contoured, and he will do this with your input while you are standing up. This method is important because our shape changes when we go from vertical to horizontal, and because the contours of the areas change when the numbing solution has been injected. Part of this plan includes deciding where it is best to place the ports, or openings where the cannulas are to be inserted to remove the fat.

Our patients are then taken to the surgical suite where they are given either twilight anesthesia by a nurse anesthetist, or if smaller areas are done, oral sedatives. Safety and comfort are always our first priorities, and with this in mind, we use the lightest amount of sedation that still keeps our patients comfortable. The areas to be treated are cleansed with surgical soap and the ports sites are then numbed with lidocaine. Through the ports, using an injection cannula, the fat is then completely numbed using a solution containing lidocaine and epinephrine called tumescent solution. The medicines in the solution provide the numbing anesthesia during the procedure, and the presence of epinephrine reduces the amount of bleeding that may occur.

Once all the targeted fat has been smoothly contoured, dressings and compression garments are placed. To ensure complete numbness and comfort during the procedure, more tumescent solution is injected than is removed during the liposuction portion of the procedure. This excess fluid is best removed by allowing it to drain from the open ports, most of which are left un-sutured and open for this purpose. The drainage of the excess fluid can be messy, and patients need to be prepared to deal with the draining fluid by using towels and barriers to protect chairs and mattresses from potential staining. It should be noted that drains are not utilized in all liposuction procedures, and that the draining period will last for just a few days after your surgery.

WHAT IS THE RECOVERY PERIOD?

After your liposuction procedure, you should expect some swelling, soreness, and bruising; however, the discomfort is typically mild and short-lived. Stiffness and soreness may linger for several days, but pain medication is always provided that will help to control any discomfort throughout the recovery period.

Depending upon how many areas, and how extensive the areas liposuctioned are, most liposuction patients are able to return to work within a week. If only one or two areas are done, such as male chest/breast or saddlebag areas, some of our patients have felt comfortable returning to work after just 1-2 days. We strongly encourage all patients to walk for 15-20 minutes the evening of their surgery to improve circulation, and to reduce any chance of forming blood clots in the legs. However, we strongly advise that you avoid strenuous activity for approximately 2 weeks.

If drains are utilized in your procedure, they will be removed 3 days after surgery, and you should be free of all bruising after about 2 weeks. The initial post-surgical swelling should be healed after 4 weeks.

LIPOSUCTION RESULTS:

Most patients will notice an immediate improvement in their shape after a liposuction procedure, despite noticeable post-surgical swelling. This swelling can make it hard to distinguish your surgery's true results, but patients should be encouraged to know that they can expect 80% of the swelling to heal by 4 weeks after their surgery. However, it is common for the final 20% of swelling to take up to 6 months before completely healing. It is typical for patients to go through a phase of firm, "woody" swelling of the liposuctioned area, followed by an itchy phase that can be quite intense, as all the nerve endings traumatized by the procedure recover. Remember, and rest assured, that all swelling and numbness will subside and return to normal.

The shape change from liposuction can be permanent. The best part is that you get to decide how permanent your results will be; as long as you maintain a healthy diet and exercise regimen, the fat will not return and your results will be preserved. It is for this reason that we encourage our patients to embrace a healthy, active lifestyle that includes moderate eating habits--this will ensure that you protect your investment.

Most of our patients find that liposuction is incredibly satisfying and worth it! The immediate results are, very often, a huge motivating factor when it comes to maintaining proper diet and exercise.