Cosmetic Plastic SurgeryCosmetic Plastic Surgery
Liposuction
It seems as if every time you turn around there is a "new, guaranteed to work" diet. Let's face it, we've all tried to look for ways to loose weight, from medication, to herbs, to sweat devices, garments, ab- roller... but the bottom line is, there is no permanent reduction of fat cells short of liposuction.
Procedure
Liposuction is a surgical procedure that removes fat from under the skin through a small incision no bigger than a quarter of an inch. Your plastic surgeon uses a tube or cannula connected to a suction machine. Popular places to perform suction are the neck, arms, abdomen, hips, buttocks, inner and outer thighs, and knees. Liposuction is used to sculpt or contour the body and improve the shape or silhouette. It works best for patients who have localized fat with good skin elasticity, have realistic expectations, and are at their ideal weight. Liposuction will not tighten muscle or skin, nor is it a method for overall weight loss. It is used in addition to but does not take the place of diet and exercise. Removal of fat is considered permanent, however, if you gain weight the fat will go to another location. Fat possibly can return in the same area that was liposuctioned but not to the same extent. It is important to keep in mind that liposuction has limitations. It will only remove fat under the skin. It will not remove fat that is inside the abdomen or under muscle. Liposuction will not change bone structure either. Therefore, your results may be limited to your own body structure. Consultation with your physician is necessary.
Methods
Tumescent and Super-Wet Technique:
a method of liposuction where the doctor injects a large volume of sterile salt
water mixed with lidocaine (an anesthetic) and epinephrine (vessel constrictor)
under the skin prior to performing the procedure. This solution is used to:
- Create a plane for suction
- Minimize blood loss
- Help with intra-operative and post-operative pain
This is probably the safest form of liposuction and can be used with suction-assisted liposuction, power-assisted liposuction and ultrasound-assisted liposuction.
Ultrasound-assisted liposuction (UAL):
a method of liposuction where an ultrasound cannula is inserted under the skin to emulsify the fat with the use of sound wave technology. It is followed by suction-assisted liposuction. Some advantages of this technology include the ease of extraction of fat, and possible decreased blood loss. Some doctors believe that UAL may add in skin tightening as well. It is the opinion of Dr. Farella that there are increased complications with the use of this technique, and other techniques are as good, if not better.
Power-assisted liposuction:
Power-assisted liposuction uses suction and gas or electric power sources to cause a reciprocating motion to help emulsify the fat for removal. There is less blood loss and ease of extraction of fat using this technique. There may be a more uniform removal of fat with the power- assisted approach that leads to improved skin re-draping. The complication rate for this technique is similar to suction-assisted liposuction.
Suction- assisted liposuction:
Suction-assisted liposuction is a method of removing fat by use of a small cannula or tube inserted under the skin through a small incision hooked up to a suction machine. The emulsification of fat is performed by the back and forth motion by the surgeon with the use of the suction machine. Suction-assisted liposuction can be used by itself or in combination with PAL and UAL.
Laser liposuction:
Laser liposuction using the SmartLipoTM (by Cynosure) or CoolLipoTM (by CoolTouch) laser removes small amounts of fat from the body using a 1064 NM or 1320 NM wavelength laser beam. It differs from traditional liposuction in that it destroys fat cells with a laser rather than using suction to remove them. The 1-millimeter laser-tipped cannula (tube) delivers a concentrated beam that dissolves fat cells and seals surrounding tissue and blood vessels. Laser liposuction can be used with traditional liposuction and may require traditional liposuction for best results since laser liposuction can be used for small areas only.
Both laser companies claim a higher degree of skin tightening compared to traditional liposuction, however, Dr. Farella cautions that this has not been proven. Skin tightening is variable, takes time, and may not occur at wavelengths used for laser liposuction. Laser-assisted liposuction was approved by the Food and Drug Administration (FDA) in November 2006.
Dr. Farella prefers using tumescent technique with both suction-assisted and power-assisted liposuction.
Ideal Candidates
- Patients who are in good health
- Patients with realistic expectations
- Patients who do not have eating disorders (such as anorexia, bulimia)
- Patients who are doing it for the right reasons (i.e. for themselves)
- Patients who are at their ideal or stable weight
- Patients who have good skin elasticity
- Patients who have localized fat under their skin.
Risks and Complications
Risks and complications may include but are not limited to scarring, bleeding, infection, rippling, skin contour irregularities, change in skin sensation, pigmentation changes and swelling, asymmetry, the inability of the skin to redrape correctly or snap back, fluid accumulations, pulmonary complications, skin loss, chronic pain, and risks and complications associated with anesthesia. It is important to remember that complications can occur, but are rare.
Risks and potential complications of surgery are best discussed at the time of your consultation.
Smokers have a greater risk of wound healing and pulmonary complications.
Recovery
Following surgery, a compression garment is worn for a minimum of two weeks to help decrease swelling and bruising, and promotes skin shrinkage. Patients are encouraged to walk as soon as possible to help reduce the swelling and prevent complications. Your recovery time is ten to fourteen days. You may resume light exercise after two weeks. For high impact exercise (i.e. step aerobics, tae bo) four to six weeks is recommended. Even though most of the swelling and bruising will resolve in one to two weeks, your final result will be observed within one year. Remember, liposuction does not take the place of diet and exercise, and the patient must maintain their pre-operation weight or continue to loose weight for the desired results.
Surgery can be done as an out-patient, under general anesthesia, or in some cases with IV sedation and local anesthesia. Surgery time is usually 1-2 hours depending on the extent of the surgery.
Liposuction is not a substitute for healthy eating and exercise, and is not a treatment for obesity. This body contouring procedure is one of the few ways to permanently remove fat cells from a particular location on the body. The quality of the skin affects the quality of the look since liposuction relies on the skin's ability to tighten.
Information on this page is not a substitute for medical consultation or advice. Please contact us to schedule an appointment to discuss the best treatments for you.
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Mount Kisco, NY 10549
(914) 997-9090
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White Plains, NY 10605
(718) 548-5200
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Riverdale, NY 10463
