Liposuction for Body Contouring: The Art
Suction lipectomy, lipoplasty, or body sculpting remains one of the most popular procedures for women in Los Angeles and Beverly Hills.
The most common areas to address with liposuction in women are the belly, flanks, thighs, knees, chin, neck, arms, and back – nearly everywhere on the body except the buttocks. In fact, once this unwanted fat is removed, it can be injected into the buttocks to restore fullness and projection into the region. This is generally an outpatient procedure and usually requires general anesthesia to get maximum results.
What are the different techniques?
There are many liposuction techniques available today. Vaser lipo, high-definition liposuction, SmartLipo, and SlimLipo are all touted as new and improved methods of safely removing fat from various areas of the body. However, the traditional tumescent liposuction remains the gold standard in fat removal and the safest technique overall. During this procedure, the fat is injected (infiltrated) with a solution containing local anesthesia such as lidocaine, epinephrine (adrenaline) and an intravenous fluid. This solution anesthetizes the fat layers and constricts the small blood vessels in the fat layer, allowing the surgeon to remove more fat with less bleeding under general anesthetic. Liposuction may also be performed under local anesthesia alone for some patients.
The other techniques mentioned above involve tumescent techniques with additional steps, and often more operating room time and expense with no clearly proven clinical benefit. Vaser may offer some skin tightening in particular patients, but again, the evidence is not conclusive and the procedure is associated with higher seroma formation risk.
Power-assisted liposuction (PAL) uses a mechanical hand piece that supplements the motions of the surgeon. Laser-assisted lipolysis (proprietary names include SmartLipo)is for smaller volume cases only and often requires more than one session to remove the fat.
Successful liposuction depends mainly on technique and patient selection and far less on the instrument used for the procedure. An experienced plastic surgeon will be able to determine your candidacy for the procedure and offer the highest standard of care to ensure a safe and effective procedure.
Patient selection may be the most important factor in ensuring a successful liposuction treatment. In the right patient, liposuction can achieve dramatic results. In the wrong patient, deformities that are difficult to correct can occur. What makes a patient a good or poor candidate relies on a number of factors ranging from skin quality, weight, fat distribution, and expectations.
Liposuction is a method of reshaping the body by removing fat from specific regions of the body. It is not a method of weight loss. In fact, in those who plan to lose weight, liposuction should be delayed until desired weight is achieved for optimal results. In those that have very little body fat, over aggressive liposuction can create contour irregularities or asymmetries.
Men and women with loose skin are poor candidates and may better be served with skin excision. In certain cases, staged procedures of liposuction followed by skin excision prove to provide the best cosmetic outcome. In such circumstances, an aggressive fat decompression procedure is first performed. three to six months later, skin excision is performed to contour the area.
Those who cannot accept the possibility of a potential touch-up procedure are not good candidates for liposuction. While the large majority of patients are satisfied after a single session, perfect symmetry is not always possible even in the best hands because healing can be asymmetric. Revisions after liposuction are almost always performed under local anesthesia in the office and help refine results when necessary.
In women with rectus diastasis (loose abdominal muscles), abdominoplasty may be preferred since liposuction alone will not flatten the belly. Muscle tightening may be required to achieve the desired result.
Liposuction is performed under general anesthesia or local anesthesia with or without sedation. Generally speaking, larger cases are better suited for general anesthesia, particularly if fat transfer to the buttocks will be included – a procedure known as a Brazilian butt lift or BBL.
The area planned for liposuction is marked preoperatively. Tumescent solution containing lidocaine and epinephrine is infiltrated under the skin. Several small incisions are made about 1 cm in length in various parts of the body to ensure crosshatching of aspiration to reduce chances of irregularity. These incisions are often placed in areas that can be hidden with underwear or bras.
Deep fat is aspirated first with larger size cannulas, and as fat extraction moves closer to the skin, thinner cannulas are used.
Patient positioning may alter throughout your surgery, depending on areas involved. The end point of liposuction may be either when the maximum amount of fat is safely extracted, or, when aspiration involves mostly blood. Liposuction is tactile as much as it is visible. The tissues are constantly assessed for thickness to ensure uniformity and symmetry.
Once the fat is removed, the incisions are closed and garments are placed to protect them during the healing process.
Recovery & Post operative Care
Garments must be worn for a minimum of four weeks after liposuction. Garments aid in keeping swelling down and ensuring uniform results. Proper garment fitting is critical to outcome. Garments that are too tight may leave depressions. Garments too loose may not properly compress the tissues and result in less optimal results.
Strenuous exercise should be avoided for at least three weeks. Close follow-up is essential to ensure garments fit properly, since swelling will subside over the course during recovery.
Final results after liposuction will not be visible for up to six months following surgery. Swelling can persist for months. Skin tightening my take up to six months in certain individuals. The amount of skin tightening one can expect after liposuction is unpredictable. Patients with moderate to severe skin laxity are counseled that liposuction has its limitations and skin excisions may be preferred.
If you have areas of fat that have simply not responded to your efforts alone, liposuction may be the right solution for you. To find out if you are a candidate, schedule your consultation with Dr. Neavin by phoning Artisan of Beauty at 310‑858‑8811 or text 323‑975‑1287.