Liposuction is the most common cosmetic surgical procedure performed worldwide.
This type of procedure works best when treating localized fat deposits. The fat tissue is removed from specific areas through small skin incisions using a hollow metal tube called a cannula, that is attached to a vacuum. The best candidates for liposuction would be at, or close to their ideal body weight, and desires to improve the body contour, and have not been previously successful with traditional diet or exercise. Liposuction can slim the hips, and thighs, can flatten the abdomen and can remove excess fat from the chin and upper arms. The treated areas will retain their new contour as long as you do not have large weight gains.
There are certain areas of the body, such as the upper arms, abdomen and inner thighs, that may develop loose or hanging skin following liposuction. The degree of skin retraction and tightness depends on the patient’s age, the amount of fat to be removed and the patient’s general skin tone and degree of elasticity. Our Lipo by Laser procedures will also aid in skin tightening, as the laser itself will help by producing more collagen at the sites that the laser passes thru.
Fat cells play numerous metabolic roles in the body. They serve as an energy source, a storage place, and interact with insulin and hormone synthesis, just to name a few. Adult fat cells are thought to be incapable of multiplying. There are a fixed number distributed in a genetically predetermined fashion throughout the body. Regardless of the function, as you gain weight these cells expand.
As you lose weight, they contract but, the number and distribution remain essentially unchanged. This is why thin people may still complain about localized fatty deposits that don't go away even at their ideal weight. Dieting reduces your weight and overall size, and may show improvement in specific areas. Liposuction reduces the overall number of fat cells, and affects shape and contour.
Fat deposits that don't respond to exercise and diet regimens are ideal targets for liposuction. If you are only overweight in certain areas of your body, you would have to lose a larger amount of weight in order to shrink the size of your thighs. The weight will come off everywhere including the breasts and face, and not just where you need it most. Most body parts can be suctioned for better contour and reduced volume, from the face down to the ankles. The most popular areas for women are the abdomen, inner thighs, outer thighs, hips,and flanks. Liposuction can even be used to reduce heavy breasts in some women.
How it is accomplished
Advances in liposuction techniques have greatly improved the results you can achieve. The procedure is relatively simple. Tiny incisions of approximately one quarter inch long are made at the sites where fat is to be removed and a wetting solution is infused to provide anesthesia, reduce bleeding and improve fat extraction. This requires careful monitoring to avoid toxicity and must be performed by those experienced with local anesthesia. We use various sizes and dimensions of cannulae, hollow, tubular instruments with holes at one end to trap the fat. The cannula is attached to suction tubing through which the excess fat is evacuated.
These instruments come in various shapes, lengths and sizes depending on the thickness and location of the fat. They have highly polished surfaces to slip through the fatty tissues with minimum friction or damage, and are frequently blunt-tipped to prevent cutting through the skin. Cannulae are inserted under the skin moved in a back and forth and criss-cross fashion within the fat, essentially pushing it aside while protecting the vessels and nerves. Fat is suctioned out through one or several holes at the tip, measured, and then the patient is checked for symmetry. The procedure is completed when a safe level of fat removal and the desired contour has been achieved. The patient is then monitored closely to make sure that enough fluid hydration has been received.
The 'wet' techniques, and the superwet technique, referring to the amount of fluids injected, are variations of the tumescent technique. Tumescent anesthesia has had perhaps the most significant impact of all developments in liposuction. Warmed tumescent liquid, a diluted solution containing lidocaine, epinephrine and intravenous fluid, is injected into the area to be treated. As the liquid enters the fat, it becomes swollen, firm and blanched. The expanded fat compartments allow the liposuction cannula to travel smoothly beneath the skin as the fat is removed. The saline softens the fat, the adrenaline decreases the blood loss and bruising, and the anesthesia provides relief from discomfort.
Ultrasound Assisted Liposuction (UAL)
Ultrasonic sound waves, like shock waves, are transmitted into the fatty tissues from the tip of the cannula probe. The fat cells are melted or liquefied and then removed by low-pressure vacuum through a suction tube. Ultrasonic liposuction is often reserved for more difficult areas to contour where the deep fat is thicker, and thus harder to extract; i.e. back rolls, upper abdomen, and flanks. It can be combined with traditional liposuction when both the deeper fat and more superficial fat are being removed. Some physicians use external ultrasound (EUAL) with liposuction in lower frequencies to soften fat deposits from the skin's surface. The literature shows limited effects of this treatment except on the tissues just below the skin surface.