Liposuction, also known as lipoplasty or suction lipectomy in the medical field, is a cosmetic surgical procedure performed on adult men and women that removes excess fat from underneath the skin. It can be used to rid you of saddlebags and love handles, and to sculpt areas such as the upper arms, calves, around the knees, the outer breast area, the back, and on the face such as underneath the chin, in the neck and in the cheeks. Liposuction is not a weight loss tool, though many people mistakenly think that it is. Liposuction can remove stubborn areas of fat that have not responded to your best efforts at exercise and weight loss.
Liposuction continues to become more refined, resulting in more precise results and a quicker recovery. At Sanctuary Plastic Surgery we offer multiple types of liposuction technology including tumescent technique (SAL – suction assisted lipoplasty), Vaser– a type of UAL (ultrasonic assisted lipoplasty), LAL (laser assisted lipoplasty) also known by brand names of prolipo or smart-lipo, and RFAL (radiofrequency assisted lipoplasty).
If you are physically healthy, psychologically stable, and have realistic expectations, you will be a good candidate. The best candidates are people who are at their normal weight and who have firm, elastic skin in the areas of excess fat. Age is not a particular consideration, though older patients may lack skin elasticity and therefore be unable to appreciate the same results as a younger patient who has tighter skin. Liposuction does carry a higher risk for people who have medical problems such as diabetes, heart or lung disease, poor circulation, or who have had recent surgery in the area to be treated. It is a particularly poor choice for smokers, as smoking diminishes the blood supply. If you’re a smoker and wish to have liposuction, you’ll need to quit smoking for at least two weeks prior to the procedure and for at least two weeks afterwards. (Better yet, quit smoking for good and enjoy the many rewards!).
At your consultation, your surgeon will explain all the body-contouring methods available and suggest the best method for your particular needs. If you want liposuction in the abdominal area you may learn that an abdominoplasty, usually called a tummy tuck, might create better results. You may also learn that a combination of traditional liposuction with VASER, PAL, LAL or RFAL might be the best choice. Rest assured, our surgeons have performed thousands of liposuction procedures and are up to date on the latest technology in this area.
How the Procedure is Performed
Liposuction procedures are performed in our Boca Raton accredited in-office surgery suite on an outpatient basis. If only a small area is to be treated, local anesthesia or local anesthesia along with IV sedation may be used to keep you relaxed during the procedure. If a large area is to be treated, you may choose to have general or epidural anesthesia. The choice of anesthesia will be made depending on which liposuction method is chosen. If liposuction is combined with another procedure, such as an abdominoplasty (tummy tuck), general anesthesia is recommended.
There are several types of liposuction performed here at Sanctuary Plastic Surgery
Tumescent liposuction or Super-Wet liposuction Large volumes of fluid are injected into the area to be treated. This fluid is a combination of saline and local anesthetic. Surgery may be performed under local anesthesia, IV sedation (twilight) or general anesthesia depending upon the areas to be suctioned. The fluid placed is used to prevent excess bleeding, control pain and give a more confluent or smoother result. We use tumescent or super-wet liposuction with all of our liposuction technology.
In both the tumescent and super-wet techniques, great care is taken to make sure that the anesthetic fluid that is injected is the correct amount to avoid lidocaine toxicity (if the solution’s lidocaine content is too high) or collection of fluid in the lungs (if too much fluid is administered).
Suction-Assisted Lipoplasty (SAL) In this technique a small diameter tube or cannula is used to suction the fat and fluid with the surgeon moving the tube in a gentle fashion in and out of the fatty area. The surgeons other hand is constantly feeling the suctioned area to compare thickness and smoothness.
Power-Asssited Lipoplasty (PAL) This technique is similar to SAL except that a machine made by Microaire is used to help move specialized cannulas into the fatty areas. This excellent technique is used for larger volume cases.
Ultrasound-Assisted Lipoplasty (UAL) and VASER liposuction requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the ultrasonic energy literally explodes the walls of the fat cells, liquefying the fat, which is then removed with the traditional liposuction technique.
Radio-Frequency Assisted Lipoplasty (RFAL) This is the latest technique to be offered at Sanctuary Plastic Surgery and at present it is only offered with an IRB study. This device uses traditional liposuction to remove fat then uses a special bipolar radiofrequency device made by Invasix to heat the skin in a very controlled fashion to cause skin tightening. This is especially useful for those patients who may be a candidate for an abdominoplasty but don’t want the scars. As in any study device the risks will be outlined during your consultation.
During any liposuction procedure, tiny incisions are made through which a narrow cannula or tube is inserted to vacuum the fat layer that lies deep beneath the skin. The cannula is used to break up the fat cells and suction them out. Our surgeons will keep your incisions as inconspicuous as possible, though there will be tiny scars where the incisions were made. These will fade with time. Fluid is lost along with the fat and is replaced during the procedure.
The length of a liposuction procedure ranges from a few minutes for liposuction of the chin area to several hours depending on the extent of liposuction performed. The length of your procedure and the anesthesia to be used will be covered in your consultation.
What to Expect During Recovery
The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even “baggy,” especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended. After surgery you will likely experience some fluid drainage from the incisions. To control swelling and to help your skin better fit its new contours, you may be fitted with a snug elastic garment to wear over the treated area for a few weeks. Your surgeon may also prescribe antibiotics to prevent infection.
Don’t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by your surgeon though you may still feel stiff and sore for a few days.
Your surgeon will give you instructions for showering and changing the dressing and you’ll be seen in the office in a few days post surgery. Healing is a gradual process. We recommend that you start walking around as soon as possible to reduce swelling and to help prevent blood clots from forming in your legs. You will begin to feel better after about a week or two and you should be back at work within a few days following your liposculpting procedure. If stitches are used they are removed or dissolve on their own within the first week to 10 days.
For small volume liposuction we will have you back in the gym in a few days. For larger volumes, we may have you avoid more strenuous exercise for about a few weeks to a month as your body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more. If you have any concerns whatsoever, come back to the office and we’ll examine you to make certain your recovery is proceeding as it should.