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The
Best Candidates For Liposuction Liposuction
can enhance your appearance and your self-confidence, but it won't necessarily
change your looks to match your ideal, or cause other people to treat you
differently. Before you decide to have surgery, think carefully about your
expectations and discuss them with your surgeon. The
best candidates for liposuction are of relatively normal weight but have
pockets of excess fat in particular areas. You should be physically healthy,
psychologically stable, and realistic in your expectations. Most important,
having firm, elastic skin will result in a better final contour. (Hanging skin
won't reshape to your body's new contours, and may require an additional
procedure to surgically remove the excess skin. This procedure will leave
visible scars.) Suction
lipectomy is not recommended if you've had recent surgery on the spot to be
resculpted, if you have poor blood circulation in that area, or if you have
heart or lung disease. You should also understand that liposuction by itself
will not improve the dimpled skin known as cellulite, though some plastic
surgeons offer other techniques which may improve this condition. All
Surgery Carries Some Uncertainty And Risk Suction-assisted
lipectomy is usually safe, as long as patients are carefully selected, the
operating facility is properly equipped, and the physician is adequately
trained in body contouring as well as general surgery. Nevertheless, in rare
instances, the procedure may cause severe trauma, particularly when multiple
or very extensive areas are suctioned at one time. Other
infrequent, but possible, complications include fluid accumulation (which must
be drained) and injury to the skin. Although serious complications are
infrequent, infection or excessive fluid loss can lead to severe illness. You
can reduce your risks by choosing a qualified plastic surgeon who has been
granted privileges to perform liposuction at an accredited hospital, and by
closely following his or her advice. The
scars from liposuction are small and strategically placed to be hidden from
view, even in a bikini. However, other cosmetic problems may occur, even if
your surgeon is very skilled. They may include rippling or bagginess of the
skin over the treated area, and pigmentation changes (such as brown spots)
that may become permanent if exposed to the sun. Asymmetry (uneven contour or
shape) sometimes requires a second procedure. Planning
Your Surgery In
your initial consultation, the surgeon will evaluate your health, determine
where your fat deposits lie, and carefully assess your skin tone. Your doctor
should explain any alternative body-contouring methods that may be appropriate
- such as abdominoplasty, or tummy tuck - and discuss the options or
combinations of procedures that would be best for you. Be
frank in discussing your expectations with your surgeon. He or she should be
equally frank with you, describing the procedure in detail and explaining its
risks and limitations. Your surgeon should also explain the anesthesia he or
she will use, the type of facility where the surgery will be performed, and
the costs involved. During
this consultation, be sure to tell your surgeon about any large weight losses
or gains you've had at any time. You should also inform your surgeon if you
smoke, and if you're taking any medications, vitamins, or other drugs. Don't
hesitate to ask your doctor any questions you may have, especially those
regarding your expectations and concerns about the results. Preparing
For Your Surgery If
you're having extensive liposuction, discuss the possibility of having blood
drawn ahead of time with your doctor. Your own blood can be used to help
replace the blood and other fluids you'll lose during surgery if your doctor
feels this is necessary. Your surgeon will give you specific instructions on
how to prepare for surgery, including guidelines on eating and drinking,
smoking, and taking or avoiding vitamins, iron tablets, and certain
medications. If
you develop a cold or an infection of any kind, especially a skin infection,
your procedure will have to be postponed. While you're making preparations, be
sure to arrange for someone to drive you home after your surgery and, if
needed, to help you out for a day or two. Where
Your Surgery Will Be Performed Suction-assisted
lipectomy may be performed in a surgeon's office-based facility, an outpatient
surgery center, or a hospital. It's usually done on an outpatient basis, for
cost containment and convenience. Extensive procedures may require a hospital
stay of two or three days. Types
of Anesthesia If
your procedure is not too extensive - that is, the amount of fat and fluid
removed does not exceed an amount your doctor will define based on your
health, body size, and surgical procedure - liposuction can be performed under
local anesthesia, which numbs the area, combined with a sedative to make you
drowsy. You'll be awake but relaxed, and will feel minimal discomfort. Some
surgeons may instead use an epidural block, similar to the anesthesia used in
childbirth. If your doctor plans to suction a large area, or to treat several
sites, you'll probably have general anesthesia. In that case, you'll sleep
through the operation. Suction-assisted
lipectomy usually takes an hour or two, but the time required may vary
considerably - from thirty minutes to several hours, depending on the area and
the amount to be suctioned. To
begin the procedure, the surgeon makes a small incision, just large enough to
allow the insertion of a hollow tube called a cannula. The opposite end of the
cannula is attached to a machine that creates a strong vacuum. The surgeon
manipulates the cannula deep within the fat layers under the skin, breaking up
the fat and suctioning it out. Sometimes additional incisions are needed to
remove all areas of fat.
If
you've had local anesthesia, you'll feel some vibration and friction during
the procedure. You may also feel a stinging sensation as the cannula moves
closer to the muscle.
You'll
lose fluid along with the fat during liposuction, and it's crucial that this
fluid be replaced to keep your body from going into shock. You'll be given
fluids intravenously, and if needed you may also receive a blood transfusion
(usually the blood you've donated in advance).
After
surgery, a drainage tube may be inserted beneath your skin for one to three
days to remove any fluid build-up that occurs. A snug elastic dressing,
girdle, or body stocking must be worn over the treated area to control
swelling and bleeding, and to help your skin shrink to fit your new contour.
You may need to wear this garment continuously for two to three weeks, then
just in the daytime for a few weeks more, depending on your surgeon's
instructions. Your doctor may also prescribe antibiotics to prevent infection. Don't
expect to look or feel great right after surgery. You'll even be heavier for a
while, because of the extra fluids you've been given. The suctioned areas will
be swollen and bruised, and you may feel a burning sensation. The pain can be
controlled with medications prescribed by your surgeon, though you may still
feel stiff and sore for a few days. You may temporarily lose all feeling in
the suctioned area; don't worry - it will return. It's
not unusual to feel depressed in the days or weeks following surgery. Try to
keep in mind that this is normal and will subside as you begin to look and
feel better. Getting
Back To Healing
is a gradual process. Your surgeon will probably tell you to start walking
around as soon as possible (to help prevent blood clots from forming in your
legs), but to avoid more strenuous activity for two to four weeks. Any
stitches will be removed in five to ten days or dissolve, and you should be
back to work in two to three days, or as much as two weeks after your surgery.
When you resume activity depends on the extent of your procedure, how you feel
and what your doctor recommends. While
most of the swelling and discoloration will be gone a month or two after
surgery, some swelling can remain for six months or more. Your surgeon will
schedule follow-up visits to monitor your progress and to see if any
additional procedures are needed. If
you have any unusual symptoms between visits - for example, heavy bleeding or
a sudden increase in pain - or any questions about what you can and can't do,
don't hesitate to call your doctor. Your
New Look Suction-assisted
lipectomy is a highly effective technique for giving you a new body contour
with very little scarring. The results can be permanent, provided you eat
sensibly and exercise regularly. If you do gain weight, you'll probably gain
it more uniformly throughout your body, not just in the former
"bulges." Most
patients are very satisfied with the results of their liposuction - they feel
more comfortable in a wide variety of clothes, and are more at ease with their
bodies. As long as your expectations are realistic, you should be happy with
your new shape. Š Copyright 2001, American Society of Plastic and Reconstructive Surgeons
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