Liposuction : Areas of the Body Treated - Those Trouble Spots
We all have a thin layer of fat covering our entire body that protects and insulates us. The distribution of body fat is affected by weight gain and loss but is also determined by genetics. This is why we all have those troubling areas that seem to accumulate fat no mater what we do. And it only gets worse with age. “Love handles”, “Saddle bags”, and “Buda Bellies” seem to stay no matter how much we diet or exercise because our bodies have been genetically predetermined to accumulate fat in a different way for each of us. Liposuction is one of the only ways to direct weight loss efforts right to those trouble spots where we tend to deposit fat the most.
Since fat exists under the skin over the entire body virtually any area can be treated using liposuction in both men and women. The most common areas that people want treated are the typical trouble spots where fat tends to accumulate with age. The bulging bellies, love handles, outer thighs (saddle bags) and the double chin are some of the most common. Arms, back (below the bra line) and inner thighs are common also. Breast reduction is also a sought after procedure to add a more youthful look and remove back and neck strain.
Permanence of Results
When you gain weight you grow adipocytes (fat cells) that fill with lipid (fat) and when you lose weight those fat cells empty out the lipid but stay in place. So they are there to simply fill again making you gain weight. This is one of the reasons why it is easy to gain weight and why repeated gaining and losing weight with dieting makes it harder to stay trim in the long run. You fill up with fat cells.
Unlike dieting, liposuction removes those fat cells permanently in addition to the lipid. It puts that area of your body back in sync with the rest of you so that even if you again gain weight it will be more evenly distributed because the excess cells in your trouble area are gone for good. In fact, a number of patients have had liposuction and have subsequently gained weight. The areas originally treated by liposuction have maintained their new shape, and even though they are heavier they still have a more desirable silhouette.
Patients considering liposuction must first be in good health. Chronic illness such as diabetes or poorly controlled hypertension or heart disease may exclude you from liposuction. There is no definite age limit. Older folks can be good candidates if they are in good health. Younger patients need to be mature enough to make a responsible decision about their health and appearance. There also is not a weight limit for patients who are otherwise good candidates for liposuction. Most of our patients are of normal weight with localized accumulations of fat. However, some of our happiest patients have been individuals who are somewhat obese. It is important to emphasize that liposuction is not a treatment for general obesity. Liposuction surgery is not a substitute for a prudent diet, good nutrition, and regular exercise and should not be seen as a last resort for people who are unable to lose weight. However, an overweight person whose weight has been stable for many years and has certain problems areas of fat may be an excellent candidate for liposuction and are some of the most satisfied patients.
Successful Liposuction Surgery
A liposuction surgery is a success when the patient is happy with the results. The surgeon’s goal is to achieve an optimal aesthetically appealing result rather than to maximize the amount of fat removed. The cosmetic success of liposuction relies on removing inches rather than pounds. For example, removing an amount of fat equivalent to a half-pound of butter from a woman’s saddlebag area or from a man’s love handle areas would result in dramatic change in silhouette, but would not significantly change the person’s weight. Although the results of liposuction are often quite spectacular, it is not realistic to expect perfection. Some minor irregularities exist after a successful procedure. It is also impossible to guarantee the precise amount of improvement that will result from liposuction but patients will generally see a minimum of a 50% improvement (50% improvement is intentionally a vague measure to indicate a definite perceptible improvement, but something short of perfection.) If at least a 50% improvement would make you happy, then it is likely that you will be very happy with the result of this procedure since our patients generally achieve more than a 50% improvement. For the perfectionist, or for liposuction of a very large area, maximum improvement may require a second procedure for which there would be an additional fee.
Although liposuction is a relatively new form of cosmetic surgery, there have been several recent improvements in the technique. One of the most significant improvements has been the introduction of the Tumescent Technique, developed by Dr. Jeffrey A Klein, M.D. in 1985. It permits liposuction totally by local anesthesia instead of general anesthesia. This technique is now considered the safest form of liposuction for removing very large amounts of fat because there is virtually no blood loss. Not only has the Tumescent Technique proven to be safer than the standard technique using general anesthesia but it also has proven to be less painful, has minimized post operative recovery time and has produced optimal cosmetic results. The Tumescent Technique has been used for many years and is well tested. It was first presented by Dr. Klein in 1986 at the Second World Congress of Liposuction Surgery in Philadelphia. His article that first described the technique appeared in the American Journal of Cosmetic Surgery in 1987.
Liposuction Totally by Local Anesthesia
The word tumescent means swollen and firm. The Tumescent Technique uses large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the vasoconstrictive drug epinephrine, which temporarily shrinks capillaries. Local anesthesia used in the Tumescent Technique for liposuction is so effective that patients no longer need intravenous sedatives, narcotic analgesics, nor general anesthesia. After the infusion of the local anesthesia the procedure is virtually painless. Patients generally chat with staff or nap during the procedure. Compared with general anesthesia the Tumescent Technique is less painful, avoid nausea and constipation associated with sedatives and anesthetic medications and it allows quicker recovery. An added benefit is that it is also usually less expensive since there is no added expense of hospital or anesthesia personnel fees.
As a result of the widespread capillary construction caused by the epinephrine in the anesthetic solution, there is minimal bleeding during and after surgery. This is a major improvement in the liposuction technique compared to older methods that simply use general anesthesia. In a recent medical study of large volume liposuction in 112 patients, each of whom had between 1,500 ml to 3,400 ml (1.5 quarts to nearly 1 gallon) of fat removed using the tumescent technique. None of these patients required a blood transfusion. In fact, the average patient lost approximately three teaspoons (15 ml) of blood. The Tumescent Technique is so effective at minimizing blood loss that the majority of patients with large volume liposuction lose less blood during the surgery than they do at the time of their routine pre-operative laboratory studies. Because of the minimal blood loss associated with the Tumescent Technique, there is no need for blood transfusions.
There is dramatically less bruising using local anesthesia for liposuction as compared to general anesthesia. There are two reasons for this: First, because there is so little bleeding with the tumescent technique, there is almost no blood that remains beneath the skin after surgery to cause bruising. The second reason for decreased bruising is that the tumescent technique uses only small punctures to introduce the suction cannulas which are so small that they do not require stitches and these wounds are open for two to three days after the surgery permitting most of the residual anesthetic solution and blood to drain out. This minimizes bruising and swelling and accelerates the rate of healing.
The drugs that are used to produce general anesthesia are relatively dangerous compared to those used for local anesthesia. It is estimated that fatal complications associated with general anesthesia occur somewhere in the neighborhood between 1 in every 2,500 patients to 1 in every 10,000 patients. The severe complications associated with general anesthesia are completely eliminated with the tumescent liposuction technique since it uses only local anesthesia. It is well recognized that local anesthesia is considerably safer than general anesthesia.
During the tumescent technique infiltrating the local anesthesia is associated with minimal discomfort. Once the area has been completely numbed, surgery in the area is essentially painless. In addition, because the local anesthesia persists in the treated area for more than 12 hours, there is no pain immediately after the surgery. Normal healing after tumescent liposuction involves a limited but definite degree of soreness, swelling, bruising, itching and lumpy firmness. A temporary mild numbness, itching or burning of the skin may persist for 2 to 10 months. This is usually drastically less than what is experienced after standard liposuction. Some patients have had liposuction by another surgeon using general anesthesia prior to having liposuction using the Tumescent Technique. Virtually every one of these patients has said that liposuction by the Tumescent Technique is a dramatically less painful experience that with general anesthesia.
Since Tumescent Anesthesia Liposuction uses very small cannulas (tubes) to suction the fat there is less damage to the tissues. This results in less inflammation and less pain. Without the side effects of sedatives there is no dizziness, tiredness, nausea, or constipation. The result is that most people have mild discomfort or aching only and return to normal activities in just 2 to 3 days. This includes work, housework and light exercise. Many patients have gone shopping or to watch sporting events the evening of their procedure.
Infections are extremely rare, but irrespective of whether or not the anesthetic technique is that of general anesthesia or local anesthesia infection can occur any time the skin is cut allowing bacteria to enter. Although there have been reports in the medical literature of patients who have had serious infections following liposuction surgery, to the best of our knowledge, there has never been any patients who have had an infection following liposuction totally by local anesthesia using the tumescent technique. One reason is that lidocaine, the local anesthetic that is used for the tumescent technique kills bacteria. Another is that since the small puncture used for the procedure are left open to drain, there is a constant flow of fluid out through the skin washing away any bacteria that may try to enter. We also use preventative antibiotics to prevent those few infections that might otherwise occur.
As with any surgical procedure, liposuction is associated with certain common side effects such as bleeding, infection, scaring, or injury. However, tumescent liposuction has an amazingly good safety record. A recent survey involving over 15,000 patients who had tumescent liposuction without general anesthesia revealed no serious complications, no serious infection, no hospitalizations, no blood transfusions, and no deaths. The greatest risks of liposuction are those associated with general anesthesia. By eliminating general anesthesia, the risks of liposuction are dramatically reduced. Patients can minimize the risk of surgical complications by not taking medications or over-the-counter preparations that might adversely affect the surgery. Patients should inform the surgeon of any medications being taken either regularly, or occasionally, including herbal remedies and dietary supplements. With the human body anything can happen anytime but Tumescent Anesthesia Liposuction is tremendously safe.
