Case Studies

Liposculpture (Liposuction) for Women

Liposuction has attained the number one position as the most common aesthetic surgery procedure done in the US.  Prior to 1981 liposuction had been done for a few years in France and Switzerland.  Plastic Surgeons in the US learned it from these French and Swiss pioneers.  At the time doctors were very skeptical of this new procedure, predicting large numbers of complications and all sorts of devastating results.  While the fears for this new procedure were certainly valid based on previous attempts at similar techniques, liposuction has proven to be a safe procedure with no more than the usual complications of other aesthetic procedures when done by well trained plastic surgeons.  Everyone has heard of some disaster or other following liposuction, but research the situation and you will usually find extenuating circumstances:  a poorly trained non-plastic surgeon, a non-accredited facility, poor judgment in postoperative care protocols.  In liposuction as well as any other cosmetic surgery procedure, it is essential for the patient to research the physician, the facility, and all other aspects of the perioperative care personnel and protocols, making sure that the highest standards of the industry as determined by the American Board of Plastic Surgery, the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery and the Association of Operating Room Nurses are being followed.

Liposculpture is a variation of the standard form of liposuction and is the method of choice for me.  With liposculpture no incisions are used, only small punctures in the skin are made to all very small (2-5mm) cannula to be inserted and thus scarring is not and issue.  These hollow metal tubes are attached to a special vacuum which removes the fat and fat cells in the subcutaneous tissue (that which is just below the skin).  Prior to insertion of the cannula, a solution (tumescent solution) is infiltrated into the areas to be suctioned.  This fluid contains certain medications that constrict the blood vessels in the area reducing bleeding and allowing larger volumes of fat to be removed at any one time.  Since the cannula of liposculpture are smaller by far than those of traditional liposuction, the amount of time in the operating room is longer.  However, traditional liposuction is usually limited to the layers of fat close to the deep muscles as using these large cannula close to the skin surface may leave indentations that are visible.  The smaller cannula allow the plastic surgeon to suction in any layer of the fat, even right up next to the skin,  with little chance of leaving behind tell-tale tracks from the cannula.

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Before Surgery

Liposculpture was designed to change the shape of the body when an undesirable shape is caused by the amount of underlying subcutaneous fat.  (Fat that is contained within the abdomen (or any body cavity) next to the organs cannot be removed by liposuction of any variety.)  Thus liposuction recontours the body.

Liposculpture in women differs from that in a man.  In women, the fat that remains behind is equally as important as the fat that is removed as the fat that remains will determine the curves of the female form.  In men the purpose of liposculpture is to remove as much fat as possible and thus expose the underlying musculature.  In women the purpose is to remove that fat which obscures the desirable feminine curves and leave behind the fat that emphasizes those curves.  If all the fat in an area of a women is removed the fluidity of the body form is destroyed and the shape is not as desirable.  Women depend on some fat, in certain areas more than others, to define the attractive contours of the female.  An eye for the aesthetic form of each sex is essential in a plastic surgeon doing liposuction.

A consultation for lipo should define the areas to be treated and the goals to be achieved.  There are limitations in all aesthetic surgery procedures and these limitations must be taken into account when expectations of surgery are being discussed.  How I have often wished for a magic wand to wave instead of a suction cannula to achieve the patient’s wishes.  The amount of fat removed will determine whether the procedure can be done as an outpatient or whether the patient must be admitted overnight for observation before going home.  Larger volumes of fat removal can result in significant fluid shifts within the body and these must be treated appropriately.  Failure to do so may result in severe complications.

The complications of liposculpture are discussed in the initial consultation.  Actually the complication rate of this surgery has been very low and I have had no cases with significant problems.

Following surgery the patient will wear a compression garment that reduces bruising, swelling and scarring.  It is generally worn for 6 weeks, depending on the rate of healing.  Most patients may return to work within 6-7 days.

The Surgery

As with all aesthetic surgery procedures, planning prior to surgery is the key.  The doctor must know exactly what to do and how.  At the IAS Surgery Center, the patients arrive shortly before the surgery is to begin.  Their anesthesia is given by a Board Certified Anesthesiologist.  The time in the operating room can vary considerably – from 1 to 5-6 hours depending on the areas to be treated and the amount of fat removed.  When the surgery is complete, the compression garment is applied and the patient is transferred to the Recovery Room.

Post Surgery and Recovery

The vast majority of liposculpture patients will be able to go home immediately after stabilization in the Recovery Room.  Outpatient surgery for this procedure is safe and comfortable.  However, as stated, if large volumes of fat are removed the patient will be required to remain overnight in the Hospitality Suite with a specially trained caregiver who will look after her needs during this time.  At home most patients will not feel like doing much.  Activity is curtailed severely.  You will be provided with prescriptions for pain and an antibiotic.  Pain is not usually a significant problem as most patients state that the area suctioned is sore and tender but not painful.  They describe it as feeling like you have just run a marathon for the first time.  Of course if you hit the area suctioned, there will be pain.  About the 5th to 6th day postop, the tenderness reduces significantly and many patients are ready to return to light work.

The body will be healing during the weeks after a lipo procedure.  After 2 weeks the bruising and much of the swelling will abate but it will be about 6 weeks before you can really see the results.  It will take about 12 weeks before you can tell about the quality of the skin and there will still be some changes for about 9 months to a year but these will be minimal.  So, don’t plan a Caribbean vacation the week after surgery.  Heavy exercise such as gym workouts, tennis, golf, etc will need to wait for several weeks.  Exactly how long will depend on your personal rate of healing.

Your return visits to the office will be at 5 days postop, each week for the next 2-3 weeks, at 6 weeks, 3 months, 6 months and at 1 year.  Your compression garment will be eliminated at 6 weeks usually.  Warm soaks begun about 4-5 days after the surgery will assist in getting rid of the swelling and bruising.

When you schedule your surgery, you are given two pages of instructions.  Make sure you follow these instructions exactly.

Risks & Complications

This is a surgical procedure and therefore complications may occur.  I can’t imagine how many times I have said this to patients during the consultation.  Frequently about this time, a glaze comes over the eyes and the patient “tunes out”.  Risks of surgery and possible complications are not the most pleasant thoughts when you are excited about getting your new look but my advice, pay attention.  The cause of a complication may not be something done at surgery, but rather something you inadvertently do in the postop period.  The list of usual complications and their causes are covered in detail at the initial consultation so listen attentively.

The Cost

When budgeting for liposculpture, remember there is the fee for the surgeon, the cost of the surgery facility and the fee for the anesthesiologist.  There are miscellaneous other costs such as lab tests, medications, preop physical, compression garments, etc.  Once you are seen in consult and all factors evaluated, a final cost will be quoted for you.  If you would like to get a general range of fees, please call the office at 404-252-3672 and ask for the patient coordinator as she will be able to ascertain your general needs and give you a baseline average cost.

 

 

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