What is Liposuction?
Liposuction is a surgical procedure used to reshape the aesthetics of the body, by removing by aspiration the fat deposits resistant to the slimming action of diet and exercise.
In addition to the traditional technique, several procedures have been developed over the course of many years to perform liposuction.
The general principle consists in the subcutaneous insertion of a thin cannula connected to a suction device, which - through opportune maneuvers of the surgeon - shatters the fat pads. When suction is activated, pieces of subcutaneous tissue containing adipocytes, blood, lymph, amorphous substance and other cells are aspirated and removed. Once the desired result is achieved, the treated area is bandaged to favor tissue remodeling. Liposuction can be performed on specific areas of the body, such as the abdomen, thighs, knees, arms or buttocks. Although the intervention is most commonly used for aesthetic body remodeling, it can also be applied to reduce breast size in men (gynecomastia) or to remove lipomas (benign tumor of adipose tissue).
The technique is commonly considered effective, safe and easy to apply. In fact, liposuction is especially suitable for people with a stable body weight, with mild or moderate overweight, who have a couple of problematic and limited points. Liposuction, in fact, is not a treatment for obesity, but a body remodeling procedure: in cases of severe overweight it is more useful to follow a balanced diet and practice regular exercise, or to evaluate any bariatric surgery procedures, such as the gastric bypass.
Several factors limit the amount of fat that can be safely removed during a single liposuction session. The removal of very large volumes (more than 5 liters) is a complex and potentially life-threatening procedure. The safety of the technique does not only depend on the amount of tissue removed, but also on the choice of the anesthetic and the general health conditions of the patient. The potential risks of liposuction and the expectations on the achievable aesthetic results must always be discussed with the doctor before undergoing surgery. Finally, with time, the adipose tissue can repopulate and the number of adipocytes can be restored. The only way to make sure that the fatty tissue removed during liposuction will not return in situ, is to adopt a healthy lifestyle, which includes a balanced diet and adequate exercise.
Objectives and Negotiable Areas
The first goal of any liposuction procedure is to remove the right amount of fat causing the least discomfort to the patient.
Liposuction reduces the accumulation of fat in a specific area of the body, such as:
- Abdomen;
- Arms;
- Buttocks;
- Calves, ankles and knees;
- Breast and back;
- Hips;
- Outside and inside thighs;
- Neck and undercoat.
Liposuction is also used for the reduction of gynecomastia (ie the development of adipose tissue of the male breast) and to treat some medical conditions, including:
- Lipomas (benign tumor of adipose tissue);
- Lipodystrophy (anomaly of adipose tissue, with redistribution of lipids in the body);
- Hyperhidrosis (excessive sweating), to remove the sweat glands of the axillary area.
Criteria and considerations on liposuction
- After surgery, the skin must reshape spontaneously around the new contours. The surgeon must therefore assess the elasticity of the skin in advance, also in relation to the amount of fat that is to be removed. If you have a good skin tone, the procedure improves the profile and the proportion of the body. On the contrary, if the treated area has a thin skin surface and has poor elasticity (as in elderly people), the skin, after liposuction, may appear loose, since it has a limited capacity to adapt readily to the new shape.
- Not all subjects are good candidates for liposuction. The ideal patients are physically active, with a stable body weight (which differs little from the ideal one) and with a good skin tone and elasticity. To undergo liposuction it is necessary to be in good health, without conditions that could complicate the surgery (infections, heart or circulation problems, coagulation disorders, diabetes or weak immune system). Liposuction is not recommended for people being treated with drugs that can interfere with blood clotting (such as aspirin, warfarin and heparin).
- Remodeling of body shapes, following liposuction, is generally long lasting, as long as the weight remains stable. If a person gains weight after a liposuction procedure, the distribution of fat can change (for example, if the abdomen has been treated, new fatty deposits can mainly affect the thighs or buttocks, making them problem areas).
- Liposuction does not improve cellulite or other irregularities of the skin surface. Similarly, the remodeling procedure with liposuction does not remove stretch marks.
- Some areas of the body respond better to liposuction, and the procedure may have varying outcomes from person to person. The density of the adipose tissue, in fact, varies subjectively and based on the body site ..
Preparation
Before proceeding with liposuction, the patient must undergo a complete physical examination (including blood tests), during which the state of health (both physical and psychological), the elasticity of the skin and the position of the bearings are evaluated. fat. If the doctor decides that the subject is an acceptable candidate for liposuction, he begins a pre-consultation procedure in which the details of the surgery are defined: which area will be treated exactly, which procedure is most suitable, what to expect during and after liposuction, what results can be obtained and the possible associated risks. Tobacco smoke should be avoided for about two months before surgery, as nicotine interferes with circulation and can cause loss of tissue elasticity. Some painkillers, such as aspirin and some non-steroidal anti-inflammatory drugs (such as ibuprofen or naproxen) must be suspended for at least seven days before surgery. Your doctor may prescribe an antibiotic to be taken before and after surgery to prevent any infections.
How it is performed
The liposuction procedures differ in some details; the ways in which they are performed depend on the specific technique, but there are some principles common to all liposuction methods. On the day of the operation, while the patient is standing, the doctor with a pen will mark circles and lines on the target areas, to mark the sites of insertion and the adiposities to be aspirated. Some photos can also be taken to compare images before and after liposuction. In the operating room, a sterilizing solution (for example, based on iodopovidone) is applied to the affected areas. A local anesthetic is then administered, limited to the specific area of the body and to the sites of insertion, or general (it induces a temporary state of unconsciousness).
In most cases, the first phase involves injecting a wetting solution into the area to be treated, composed of physiological solution, epinephrine (to reduce bleeding) and a local anesthetic (to temporarily minimize the pain both during and after treatment). surgery). The surgeon proceeds by making a small incision (or more incisions) in the area, through which he inserts a thin cannula connected to a vacuum pump by means of a flexible tube. By quickly manipulating the cannula back and forth, the surgeon can separate and remove excess fat cells; during the various phases the doctor repeatedly checks the quantity of liquid and fat that are sucked and collected; meanwhile, if the patient is alert, he only feels a scraping sensation caused by the movement of the cannula.
The surgical team will monitor heart rate, blood pressure and blood oxygen level throughout the procedure. Overall, the intervention can last from one to four hours, depending on how much fat is removed, the removal technique and the number of sites that are sucked in until the desired result is achieved.
After the procedure - to help drain the liquids from the liposuction site - the surgeon can leave the incisions open or apply a couple of stitches. In some cases, the doctor may insert a drainage tube. Patients should be aware that in post-surgery they may appreciate leaks of pink-colored liquid through the insertion holes of the cannula, for about 24 hours. This process is normal and helps to minimize the appearance of bruises. In any case, during drainage, dressings must be changed regularly. After about three days, the application of some self-adhesive bandages is sufficient.
The tissue layers deprived of fat and collapsed during healing will create the new body shape. For this reason, after liposuction, the patient must wear a compression compression garment.
Read the in-depth analysis on the various Liposuction Techniques
Recovery and results
Recovery is fairly rapid and can vary based on factors such as the volume of fat cells removed and the area undergoing liposuction. The patient can be discharged the same day in case of local anesthesia or be hospitalized for at least one night, at the medical or hospital facility. Spending a few hours in clinical observation allows the medical staff to monitor the patient's post-operative recovery. The stitches at the incision sites are removed after about 10 days and minimal scars may remain where the doctor has cut the skin to insert the cannula. Walking just after surgery can help prevent thrombus formation in the legs. After liposuction, many patients experience pain, numbness, tingling or burning during the recovery process, but these symptoms usually disappear within six to eight weeks. After liposuction, swelling and bruising may also appear, which can take anywhere from 4-6 weeks to six months to fade to disappear. The surgeon can prescribe analgesics to help control pain and antibiotics to reduce the risk of infection. Furthermore, it may be necessary to wear special support clothing, which compresses the affected area to reduce swelling and promote the remodeling and healing process; the compression sheath must therefore be elastic and allow the use of dressings.
The final result of liposuction will be evident within a couple of weeks, even if it takes a few months for the swelling to disappear making visible the aesthetic improvements produced by the intervention. Depending on the extent of liposuction, it may be necessary to wait a few days before returning to work and a couple of weeks before resuming normal activities, including exercise. In some cases, the patient can return to work within 24-72 hours after the procedure. The results of liposuction are generally long lasting, as long as the body weight remains stable over time; in any case, it is important to understand that liposuction will not in any way prevent weight gain. To maintain the new shape obtained with liposuction, it is therefore necessary to follow a balanced diet, associated with regular exercise.
