Liposuction
Liposuction, also known as Lipoplasty, is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck.  Today, a number of new techniques,  the tumescent technique, ultrasound-assisted lipoplasty (UAL),, and the super-wet technique, are helping many plastic surgeons to provide selected patients with more precise results and quicker recovery times.  Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don't respond to traditional weight-loss methods.

Liposuction can be performed under general anesthesia (in which you are completely asleep), sedation (very relaxed in a light sleep), or under local anesthesia depending upon Dr. Brill and your medical circumstances.  Depending on how many areas are being worked on, surgery lasts from 30 minutes to 6 hours. In addition to fat, Dr. Brill also removes body fluid in the procedure. Because of this, patients are given fluids intravenously during the operation.

There are two basic techniques used in liposuction; Tumescent and Ultrasonic. Both techniques share core surgical elements. In fact, even if ultrasound is used, it will be followed by tumescent liposuction.

Tumescent liposuction is also known as standard liposuction, liposuction, lipoplasty, liposculpture, liposculption, and suction-assisted lipoplasty. This type of liposuction has been performed in the United States since the early 1980’s. First, Dr. Brill fills the fat with tumescent fluid (a solution containing saline and local anesthetic). Then, the fat is suctioned with long thin rods. The procedure can now be performed through a few small incisions, which can be hidden with natural skin creases. The tumescent technique may reduce blood loss and alleviate pain. The local anesthesia may be supplemented with intravenous sedation or general anesthesia.

Ultrasonic liposuction also starts with filling the fat with tumescent fluid to make the fat stiff. However, the fat is not suctioned, but liquefied with high-frequency ultrasonic energy with a long thin rod that emits ultrasonic waves. The rod is inserted into the fat through a tiny incision and then, the fat is suctioned out.

 
                                                        Consultation

At the initial visit, Dr. Brill will ask you to describe in detail what you would like improved. Be specific about what you would like done. If Dr. Brill fully understands your expectations, he'll be able to determine whether your goals are realistic.  He will evaluate your overall weight, your skin and muscle tone, and the distribution of fat deposits to determine which techniques will be employed, where incisions will be made and what results can be achieved. Your skin type, thickness and texture, your age, if you are a smoker and pre-existing sun damage as well as other factors will all affect the final result.

While liposuction will rapidly reduce body fat, the goal is lifetime maintenance. This is why long term success of maintaining the optimal body shape after liposuction procedure depends on individual life styles, including proper diet and exercise.  With proper diet and exercise the results of liposuction are long lasting and dramatic.

 A  Good Candidate:

• Is close to their ideal body weight (within 30%)
• Wants to remove specific areas of fat that are diet- and exercise-resistant (fat pockets in the abdomen, arms, knees, inner thighs, love handles, neck, outer thighs)
• Weight has been stable for 6 months or more
• Has good skin tone and elasticity
• Does not have loose or saggy skin
• Has realistic expectations and is emotionally stable
• Understands the risks and benefits of surgery

If you do not meet all of these criteria, but meet some of them, you may still be a good candidate for liposuction. The procedure is most suited to those who are close to their ideal body weight, but if you have a lot of fat in an isolated area, you may still be a good candidate. Some patients find liposuction to be a good incentive for weight loss, but it is not a remedy for obesity.  If you have good skin tone, it is more likely that your skin will respond well to the surgery. Patients with saggy skin or stretch marks are more likely not to tighten and may in some cases look worse. A thigh lift or tummy tuck (depending on your problem area) may be more effective.

The quality and elasticity of the overlying skin has a major impact on the success of liposuction. When fat is suctioned to remove a bulge, the overlying skin must shrink or contract to fit the new profile. If your skin is excessively loose before the procedure, the additional looseness after suctioning may be undesirable.  Dr. Brill will discuss the elasticity of your skin during your consultation.

So to summarize, to be a good candidate for liposuction, you should have localized fat deposits (not be grossly overweight), and have elastic skin overlying the fat deposits.

Procedure D etails /Expectations:

• The procedures are done on an outpatient basis.
• General anesthesia is usually used for safety and comfort.
• Small suction tubes (cannulas) are inserted through very short incisions placed in inconspicuous locations near the fat deposits, and excess fat is removed.

Although the new shape of your body usually begins to emerge in the first few weeks, some swelling may remain for several months. Major weight gain or loss after liposuction can produce skin surface irregularities. The final result may not be clear until 6 months after surgery.

Many people assume that because liposuction permanently removes fat cells, it's impossible to regain weight in the treated areas. This is only partially true. Adults have a fixed number of fat cells, and liposuction removes some of these cells permanently. The remaining fat cells can grow bigger, especially if you do not exercise and maintain a healthy diet. This means problem spots can return. However, weight gain after liposuction will usually be distributed to other parts of your body instead of settling back into the old problem areas.

Recovery:

After surgery, you will wear a body-compression garment. You must wear this for several weeks. After surgery, you will need to make arrangements for a responsible adult to care for you for the first 24-48 hours.  Bandages are changed in 1-2 days (drains and sutures removed within 5-10 days). Recovery from liposuction can be uncomfortable, but most people are back to work within 10-14 days. During the first few weeks most people experience varying degrees of pain, burning, swelling and temporary numbness. Pain medications can alleviate discomfort and a body-compression garment will minimize swelling. You will need to refrain from any exercise other than walking for about a week after the procedure. Slowly work your way back to your existing exercise routine giving yourself at least 2-4 weeks to regain your normal workout routine.  Swelling will last from 2 weeks to 2 months or longer in some cases.  Bruising will usually last 2 days to several weeks depending on procedure and healing time.  Many people also experience numbness that can last only a few days to several months.

Surgical scars are usually minimal and are permanent. However, usually only two small incisions (less than 1/4") are made for each area. Incisions are often placed in natural skin creases, are hidden in pubic hair, or inside the belly button so that they are not normally noticeable except on very close observation. Certain areas are easier to hide than others.  To keep scar tissue soft and minimize their appearance, massage them and keep them out of the sun. Massage them with scar minimizing/reduction creams.

For faster Recovery: 

• Drink adequate amounts of liquids to prevent dehydration.
• Avoid alcoholic beverages for 48 hours before and after surgery.
• Wear compression garments as suggested to prevent slow healing and excessivedrainage.
• Do NOT apply ice-packs or a heating pad to skin overlying the liposuctioned areas.
• Do NOT apply hydrogen peroxide or plastic Band-Aids to incision sites.
• Do NOT soak in a bath, Jacuzzi, swimming pool, or the ocean for at least 7 days after surgery in order to minimize the risk of infection.
• Reduce your risk of fainting at home by: standing up slowly after urinating, remove compression garments slowly, have assistance for your first shower and sit down if you feel dizzy or lightheaded. 

Risks / Complications:

Blood Clots: (or deep venous thrombosis, a DVT) can forms in the deep veins of the pelvis or legs after any surgery. A blood clot forms after prolonged immobility (people on international flights, women on bed rest during pregnancy and patients recovering from surgery are the most susceptible to blood clots). It is important to stand often (at least once an hour), flex the feet more often and generally keep the blood flowing in your legs. If the blood pools for too long in one area, you could be at risk for a blood clot.

Perforation: of the abdominal wall or bowels is preventable during surgery. Surgeons are limited in what they can see during surgery and must take extra caution. Choosing a highly experienced surgeon like Dr. Brill can reduce your risk of such complications.

Shock and hemodilution: (shock and blood dilution) can occur after a patient has had excessive amounts of fluid injected and then excessive amounts of fat and body fluid removed (over 5,000 cc's, about 11 pounds). Large volume liposuction should be considered carefully. It is generally not recommended.

Lidocaine: use poses particular hazards, especially since experts do not agree on safe injectable levels.  At least one study links possible lidocaine toxicity to liposuction deaths. People with less than normal liver function or those who have been drinking alcohol may not be able to metabolize lidocaine well.

Tummy Tuck vs. Liposuction of the Abdomen:

If you have excess abdominal fat, no stretch marks and fairly good skin tone, you are a good candidate for liposuction. If you have stretch marks, loose skin and a loose inner girdle (all more likely after pregnancy), a tummy tuck is probably your best choice.

Additional procedures that may enhance the result are Tummy Tuck(Abdominoplasty), Breast Reduction, Thigh Lift, or Buttocks Lift.

Risks / Complications:

The specific risks and the suitability of this procedure for a given individual can be determined at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.  Risks common to all surgical procedures such as bleeding, fluid collections, infection and scar tissue formation occur in a very small percentage of cases. We will give you more detailed information about these and other rare risks in our written information, and encourage you to discuss any which concern you during your consultation.

Notes:

You are at increased risk for complications from liposuction if you have diabetes, poor circulation, heart, lung or liver disease, smoke, have a family history of blood clots, take certain medications, etc. You'll want to discuss your medical history thoroughly with Dr. Brill before you choose to undergo surgery.


        If you feel Liposuction is a procedure you are interested in, please call us today
                                                        for an appointment at: 
                                
                            352-331-7987 or 1-800-428-8419