Unwanted fatty deposits? Unfortunately, there is no substitute for dieting and we all understand that weight loss is not as easy as it sounds. Liposuction may be the cure. Also known as liposculpture, this popular technique involves removal of fat via tiny incisions to improve your body’s contour. Commonly treated areas include the abdomen, back, armpit region, thighs, lower legs, arms and also the under the chin region. Results can be quite dramatic in the in the correct candidate.
When performing liposuction, we seek to alter the body contour in a manner that emphasizes the desired curves of the body and the underlying muscular structure. This is called by some fort high definition liposuction or liposculpture. The beautiful curves of the body can be accentuated in a more natural fashion.
Who is the best candidate?
Liposuction may be performed on physically healthy men and women who are of normal body weight but have stubborn areas of excess fat. This is commonly seen around the face (chin, cheeks, neck), and body (upper arms, abdomen, flanks or “love handles”, buttocks, hips, thighs, knees, calves, and ankles). Liposuction patients should have relatively elastic skin, so as the best results are achieved. Liposuction is not recommended for individuals with certain health conditions such as diabetes, heart or lung disease, or poor circulation. A consultation with your surgeon is recommended, in order to determine whether you are a good candidate for this procedure.
* Individual results may vary.
View before-and-after pictures of real patients of George Volpe, M.D., F.A.C.S.
While the basic principle for liposuction has essentially stayed the same for many years, there are many types of liposuction that are now available in the marketplace. Among these include laser, ultrasound, waterjet, radiofrequency, and power assisted types of ultrasound. Most studies show that there is no difference between the various methods. The vast majority of board-certified plastic surgeons prefer, as I do, the tumescent technique. This effective technique is felt to have the lowest risk of complications compared to those seen on many of the other techniques that employ high energy. This technique which has been around for many years minimizes bruising and helps achieve a smoother result.
There are a number of noninvasive techniques available for changing one’s body contour. These can include Sculpsure and CoolSculpt which cause warming or cooling of fat cells until they dissolve, and can also include Kybella which is an injectable medication that dissolves fat cells. In general, these techniques can be used when one has a small amount of unwanted fat and if one has realistic objectives. Invasive techniques such as liposuction allow for a much greater removal of fat with a much more dramatic change in contour.
Written on November 24, 2018
“The result was even better than I expected! I was ready for a change. I can’t thank Dr. Volpe and his staff enough for the great job they did!”
How does tumescent liposuction work?
Tumescent liposuction is a time honored safe and effective technique for contouring the superficial fat of the body. After thorough discussion of concerns and objectives both during your consultation and prior to the procedure, the contours of the body area to be treated are marked. Tumescent fluid, which is a mixture of sterile water with very dilute local anesthetic and adrenaline, is injected in the area to be liposuctioned. The volume of the water helps spread out the fat cells to allow for a more even result from liposuctioning. The local anesthetic provides relief from the discomfort and the adrenaline is used to minimize any bruising.
The liposuction procedure
Very short incisions are made in discreet areas such as skin folds or pre-existing scars. Careful attention to incision placement avoids the telltale signs of liposuction from misplaced scars. Suctioning is performed with thin tubes called cannulas which are connected to a vacuum source. There are a number of sub techniques that I utilize when performing liposuction including SAFE liposuction, high definition liposuction and for some, abdominal etching. When the contour that is the objective is achieved, the incisions are closed, usually with a single nonvisible stitch under the surface of the skin which dissolves. No need to have sutures taken out!
When the liposuction procedure is finished, a layer of foam is placed over the area treated for several days. On top of this an elastic compression garment (cinta, faja) is worn for several weeks. The garment can be removed for showers and such but does serve important functions. Initially, the garment helps minimize swelling and bruising and over the next several weeks helps guide the skin as it settles into the new shape.
In general, as with many plastic surgery procedures, the final results of liposuction may take 3 to 4 months and sometimes longer. Most of the swelling and bruising dissipates in two or three weeks and one notices a dramatic change in appearance at this point. Time for compliments from family and friends! However there still are normal healing changes that take longer. I often employ post-liposuction massage to the treated areas which can be performed by yourself or by an experienced post-liposuction massage therapist.
Some patients elect to undergo fat transfer. This procedure involves reinjection of fat that has been suctioned into areas where volume is desired. This technique is used in a number of body areas including the buttocks, breasts, and face. Similar to grafts of other body tissue types such as skin grafts and bone grafts, fat that is injected is considered a fat graft. This newly injected fat incorporates itself into the new area but like all tissue in the body, requires oxygen and nutrients through the circulation- this process takes a number of days and special care is taken to protect the areas where fat has been transferred.
Anesthesia for liposuction
Liposuction can be performed under local anesthesia or under more general (sleeping) anesthesia. Local anesthesia is usually reserved for the correct candidate who is undergoing smaller area liposuction. Sometimes this can be performed in the office. However, when one is undergoing larger volume liposuction or in more than just one or two areas of the body, general anesthesia may be preferred.
Who is the best candidate for liposuction?
The ideal candidate for liposuction is one who is healthy but has unwanted superficial fat with good elastic skin tone overlying the area. When the fat is removed, the skin contracts down and one achieves a thinner contour. However, there are limits as to how much the skin will contract. If one has significant extra skin over the area where fat is removed, there may be some excess skin which could result in a slight waviness if the tone is not sufficient. Stretchmarks also make it more difficult for the skin to contract. This does not mean that liposuction should not be performed if one is not a perfect candidate, however a realistic discussion is certainly needed along with a good physical exam to determine what the outcome would be should one undergo liposuction. There may be other alternatives. For example, if one has significant redundant skin in the stomach area, an abdominoplasty (tummy tuck) may be more appropriate. Liposuction is certainly a smaller procedure than an abdominoplasty and it is not unusual to decide to undergo liposuction if one has realistic expectations.
The decision to modify your body contour should not be taken lightly and all options should be evaluated. A consultation includes a discussion on your goals, lifestyle, nutritional habits and in general health, combined with a careful physical exam.
At your appointment we will review your objectives, all alternatives and their pros and cons and help you make an informed decision in choosing the right path to your desired shape!