We tend to picture young and beautiful bodies as slender, sculpted, and well proportioned. Unfortunately, as we age and exercise less, we begin to add-on a few extra pounds each year, and before we know it, the person we see in the mirror no longer resembles the lean and svelte image we remember from our recent youth. Sometimes, the problem is not the weight we see on the scale, but the disturbing shape we see in the mirror, and how our clothes just don’t fit right any more. Plus, our hectic modern lifestyle prevents us from exercising as much as we’d like or eating a healthy, low fat diet like we know we’re supposed to. Occasionally, hereditary factors are the culprit, conspiring to keep us from resembling the ideal, and we believe we are destined to live with mom’s hips or dad’s double chin. Many of us have even experimented with various diets and exercise routines to combat these areas of unwanted fat, most often to no avail. If you have localized areas of unwanted fat that you simply cannot lose, the problem may be genetics and lifestyle – liposuction may be the answer!!
Liposuction, sometimes called LipoSculpting, is a minimally invasive surgical procedure that removes bothersome, localized, disproportionate deposits of excess fat from specific areas of the body, face and neck. Popular liposuction procedures include slimming the stomach, hips, flanks (the “love handles”), thighs, or eliminating a double chin. Liposuction is the most popular cosmetic surgical procedure performed today. Often, patients desire fat transfer of their own fat from the undesired areas to augment other parts of their body, most commonly their butt, this is called a Brazilian Bubble Butt Lift®.
Because of the relative simplicity of the concept, “vacuuming” unwanted fat from areas of the body, many doctors have started performing “awake” liposuction in their practices after taking weekend courses, without formal, fellowship training in Cosmetic Surgery or Aesthetic Plastic Surgery. This is very dangerous for patients, and patients need to realize that it is often impossible to fix bad lipo. The scarring and contour deformities that can result when untrained doctors try to perform liposuction on unsuspecting patients are permanent and can be mutilating. Repairs require complex procedures with scar release, redo liposuction with advanced VASER technology, and fat transfer.
Patients must also be aware that liposuction may not be the appropriate procedure for all cases, and that there are limitations as to the amount of fat that can safely be removed in a single operation. Liposuction is not a substitute for weight control. It is important to know the proper indications for the procedure, to be able to discuss alternatives, and to manage potential risks.
Am I a candidate?
Body contours made irregular by excess fat accumulation such as the lower tummy, the flanks (“love handles”), outer thighs, or the arms can be improved by liposuction. Generally, these areas are not responsive to diet or exercise, and are persistent even when you are at your ideal weight – hence the medical term “persistent lipodystrophy.” The best results with liposuction are obtained in younger patients with resilient skin elasticity so that the skin will smoothly re-contour after the procedure. In some older patients, or in those with more long-standing localized fatty excess, the skin may be stretched and inelastic. In these instances liposuction alone may be insufficient, and even laser or VASER liposuction may not be able to adequately tighten the skin. In these instances a skin tightening procedure (such as a Tummy Tuck, Body Lift, Arm Lift, or Inner Thigh Lift) may be required.
Liposuction cannot correct contours that are irregular for other reasons, such as muscle weakness, hernia, or pre-existing contour defects and scars. Also, it is not applicable in cases where there is excessive skin laxity (for example, the abdomen after multiple pregnancies) or “cellulite.” However, combined with additional procedures, liposuction can often correct these other deformities with good results. For women with large, saggy breasts that are mainly fatty, not dense breast tissue, liposuction, especially combined with VASER liposuction, can be used to perform Breast Reduction with minimal scars. VASER Liposuction is also a primary treatment for Gynecomastia, or Male Breast Enlargement, where there is localized accumulation of excess fat and breast tissue in men.
The areas that respond well to Liposuction include:
- Neck and lower face (jowels)
- Upper arms
- Breast fat or chest areas
- Flanks (“love handles”) and Upper Back
- Abdomen and waist
- Hips and buttocks
- Inner and outer thighs
Liposuction is a Body Contouring technique, not a method of surgical weight loss. Even in large-volume liposuction, although there is usually a noticeable and often dramatic improvement of the body contours, there may be relatively little change in the patient’s weight post-operatively, since fat is less dense (lighter in weight) than a comparable volume of water. Liposuction is not effective on diffuse, generalized, or intra-abdominal excess fat (inside the abdominal cavity, under the muscles – i.e. the typical “Beer Belly”). Dr. Rodriguez advises such patients that a medically supervised weight reduction program and possibly bariatric surgery is most beneficial in such cases. Liposuction works hand-in-hand with a healthy, low-fat diet and a program of regular exercise, to restore your shape, or to create the shape you’ve always dreamed of, minus the unwanted bulges that never seem to go away, even with your best efforts at diet and exercise.
During your consultation, you will be asked to point out your areas that concern. It is important to have realistic expectations about what can (and cannot) be achieved by the procedure. Liposuction is most successful in people of normal body weight with good skin tone who have isolated, localized unwanted fatty deposits. It is not a treatment for obesity, and usually, your weight will not change markedly following the procedure. Rather, the procedure will result in improvement of contour. Most importantly, it is important for patients to understand that perfect symmetry between the two sides of the body is never possible. Also, if significant weight gain occurs following liposuction, the resulting fat may be deposited irregularly in the areas that were treated, resulting in a lumpy, bumpy appearance, also with accelerated fatty deposition in the parts of the body that were not treated with liposuction. Both of these scenarios would require another liposuction procedure, and redo liposuction procedures are more challenging than first-time procedures due to the underlying scar tissue from the first liposuction surgery.
A variety of factors can affect your results: physical condition, genetic makeup, diet, exercise, smoking, alcohol intake and skin elasticity. As part of the consultation, Dr. Rodriguez will carefully evaluate your general state of health. Any underlying conditions that may compromise your result, and any medications or supplements you are taking, should be discussed in detail. I will estimate the amount of fat that should be removed from each individual area of concern, in order to achieve the optimal result.
The Liposuction Procedure
During the past decades, liposuction has benefitted from several refinements – most notably the introduction of tumescent anesthesia and micro-cannulas. Because liposuction is now performed with tumescent anesthesia, some doctors advertise “awake” liposuction procedures. But this has limitations, since the procedure must be performed slowly and patients still feel discomfort from the movement of the cannula, despite the local anesthetic. This ultimately limits how aggressively the surgeon can target the fat and limits their result.
Dr. Rodriguez prefers to perform liposuction under a light general anesthesia in addition to the tumescent anesthesia in a surgical center. This is safer and more comfortable for the patient. The tumescent is a sterile salt-water (saline) solution with lidocaine (local anesthetic like the dentists use) and adrenaline (which causes the blood vessels to shrink – thereby minimizing any bleeding or bruising). The tumescent minimizes any blood loss and bruising during the procedure, protects against “fat embolism,” and provides long-lasting pain relief both during and after the procedure. Because Dr. Rodriguez infiltrates the tumescent solution after the general anesthetic, the injections are truly painless.
Dr. Rodriguez uses a “super-wet” tumescent technique to fill and inflate the areas that are to be treated. This makes the liposuction safer as well as painless. Because of the “super-wet” technique, patients may have “leaking” of the excess tumescent solution for the first few days after the surgery.
By performing liposuction in the hospital setting, Dr. Rodriguez can focus on truly sculpting his patients’ bodies under the safest possible conditions.
Once the tumescent solution has been delivered to all areas to be treated, Dr. Rodriguez will then deliver either the VASER or laser energy, if VASER or laser liposuction is being performed, then he will begin the liposuction procedure. Dr. Rodriguez specializes in minimally invasive, micro-cannula liposuction. Small, discreet incisions are hidden in natural skin folds and placed as inconspicuously as possible. Micro-cannulas are small metal suction tubes of variable size (2.5 – 3.5 millimeters) that are attached to a surgical vacuum machine and inserted through the small incisions into the fatty deposits requiring treatment. Dr. Rodriguez uses a multiple-vector sweeping pattern with multiple entry sites as he aspirates the fat to ensure a smooth contour enhancement. The use of micro-cannulas, in combination with the tumescent anesthesia, further protects modern liposuction patients from the risk of any “fat embolus.” The procedure may take an hour or more, depending on how many areas will be treated. Our patients often combine liposuction with other procedures, such as liposuction to the flanks and back at the time of their tummy tuck, with or without fat transfer to the butt.
In addition to traditional vacuum Liposuction, there are other types of instrumentation, which can be useful in certain situations:
- Power-Assisted Liposuction (PAL) – In select cases involving areas of dense or fibrous fat, redo liposuction cases, or large volume liposuction cases Dr. Rodriguez may utilize The PowerX Lipo System, which has several key advantages over other vibration-type, “tickle lipo” liposuction devices on the market. The Power X Lipo System creates a rotational motion of the cannula, which allows Dr. Rodriguez to remove fatty tissue all the way around the cannula, rather than just above or below the orifice. The wide range of settings further allows Dr. Rodriguez to tailor the system to any body contouring application, from gentle, superficial work to more aggressive large volume fat removal. This enhances passage of the cannula through the fat, and the fat is simultaneously vacuumed away, as in traditional liposuction.
- VASER Liposuction – Although VASER Liposuction sounds like Laser Liposuction, the two technologies are very different. VASER uses high-frequency ultrasound to pre-treat fat and skin before the actual liposuction procedure. VASER stands for “Vibration Amplification of Sound Energy at Resonance,” which is a fancy way of describing what high frequency ultrasound energy is. VASER Liposuction is very useful for redo liposuction cases, liposuction for men (because men have very dense fat), and also for harvesting fat for fat transfer (because the VASER does not destroy the fat cells, and actually enhances the quality of the fat for transfer). Click here for more detailed information regarding VASER Liposuction.
- Laser Liposuction – The clinical term for this type of procedure is laser-assisted lipolysis (also called laser lipolysis or laser lipo for short). SmartLipo and Lipotherme are brand names for some of the different lasers that can be used. Both laser liposuction and VASER liposuction help with additional skin tightening after liposuction. The difference is that laser liposuction melts and destroys the fat cells, so they cannot be used for fat transfer. Both technologies are useful, and because Dr. Rodriguez has extensive experience with both VASER and laser liposuction, he offers his patients the “Smartest Lipo” – ensuring that they receive the best possible option for their individual needs. Please click here for more information regarding laser liposuction.
Can my fat from the liposuction be used anywhere else?
Yes. Fat transfer is a specialized process wherein the fat taken from areas of excess can be transferred to other areas where you desire increased fullness and suppleness. Fat transfer is wonderful for gluteal contour enhancement with butt augmentation as part of a Brazilian Bubble Butt Lift®. Fat transfer can also restore the youthful contours and fullness of the face for Facial Rejuvenation, and the stem cells in the transferred fat also improve the texture and quality of the facial skin for optimal enhancement. Often, however, our patients achieve more consistent results with dermal fillers and platelet rich plasma in our MedSpa for facial rejuvenation, without the associated bruising of a formal fat transfer procedure.
Patients sometimes ask if their fat can be transferred to the breast for a Natural Breast Augmentation to modestly increase their breast size without using implants. Unfortunately, fat transfer for breast often only increases breast size by only one cup size, and often fails to enhance the upper breast fullness that most women desire. Hence, most patients prefer a formal breast augmentation procedure with implants, and choose to use their fat for gluteal augmentation.
Options & Alternatives
Liposuction, even with VASER or laser Liposuction, will not correct severe laxity of the skin, and in fact may worsen the appearance of areas with very loose skin or severe cellulite. In such instances, an alternative body contouring surgical procedure may be required, most commonly in conjunction with liposuction of the involved area(s). For excess, lax skin of the abdomen and hip areas, Abdominoplasty, with or without a Posterior Lower Body Lift (for an Around-the-World Tummy Tuck) may be required. Loose skin of the upper arms may require Brachioplasty (Arm Lift), and sagging skin of the inner thigh region may require a Thigh Lift. A severe double chin may require Facelift or Neck Lift in order to achieve the desired outcome.
Although most patients have uncomplicated recovery after liposuction, there are occasional problems or complications which may occur. Permanent problems are quite rare. Potential short-term complications include bleeding, infection, and reactions to anesthesia. Cosmetic complications include contour irregularities such as depressions or wrinkling of the skin, discoloration of the skin, asymmetry when comparing one side to the other, scar tissue, tape burns, and collections of blood (hematoma) or fluid (seroma) under the skin. Additional surgical procedures may be required to correct these complications, and there may be additional financial expense, loss of income, and inconvenience to you. Uncommon complications include loss of sensation or movement in a body area, skin breakdown or loss requiring skin graft or reconstruction, and fat embolism or blood clots in the lower leg veins which may travel to the lungs (pulmonary embolism). Serious infection, or shock requiring hospitalization and blood transfusion, are exceedingly rare. Some bleeding and fluid shift is expected during liposuction, especially after large volume liposuction. Because of this, to maintain the safety of the procedure, there is a limit on how much fat can be removed at one time. For most large volume liposuction procedures, Dr. Rodriguez usually admits his patients as a planned 23-hour observation overnight stay. If it is evident that very large volume liposuction (beyond the safe limit of a single operation) is required to achieve a patient’s goals, then this requires a staged approach, with multiple operations separated by recuperation intervals of several weeks or months, in order to safely accomplish the desired goal.
What about Recovery?
Your recuperation from liposuction surgery is relatively easy. Most patients awaken with little or no pain as a result of the tumescent anesthesia and are mobile immediately after liposuction, although an extra day or two of bed rest may be needed when large amounts of fat are removed. Keep in mind that healing is a gradual process. Initially, you may feel somewhat swollen, stiff, and sore. The day after surgery, you should be up and walking around to promote normal circulation. You should begin normal activity as soon as possible to reduce post-operative complications, but in some cases I may advise to avoid strenuous activity for a few weeks. Light exercise (such as leisurely walking) is usually permitted within a few days. You should expect some bruising, swelling and pain after your procedure. There will most likely be some bruising after your procedure, and this resolves over the first two weeks. If you feel like you’ve lost sensations in the areas treated, don’t be alarmed. As your nerves begin to regenerate feeling and sensation should return to normal. Swelling may linger for as long as several months. Pain medication will be prescribed to control any discomfort, however, if you begin to have severe pain, contact us immediately. Most patients do well with Aleve and Tylenol over the counter medications. The swelling tends to resolve most dramatically after the first 4-6 weeks, although the final result and skin tightening after liposuction takes 4-6 months.
You will wear special elastic compression garments provided to apply pressure, minimize swelling and provide support while healing. These garments also assist in retraction of the skin, and although they may be somewhat hot and uncomfortable, they must be worn continuously for the first 6-8 weeks after surgery, except when showering, in order to maximize your cosmetic outcome. After the first 6-8 weeks, the compression garment can be used for support and comfort as desired, for an additional 3 weeks. You will be sent home in a primary, black colored compression garment that will resist staining from the leaking of the tumescent fluid the first 2-3 days after surgery and which has zippers to make it easier to put on after showering. You will wear this black garment for the first 5-7 days, at which point you will switch to the secondary, skin colored garment once the leaking has stopped and your initial swelling has gone down. This secondary garment has no zippers and is to be worn for the remainder of the 4-6 weeks. The zippers are to be avoided as they can create contour defects along the sides. Compression after liposuction to the arms and chin is different and will be discussed during your consultation.
You may shower on the second or third day following surgery, but no bathing, swimming, or hot tubs until 4-6 weeks after surgery. Depending on the number of areas treated, you will be ready to return to office work in 3-5 days, and more strenuous activities at 10-14 days. You may increase your activity daily until full activity is resumed at 2-4 weeks. Avoid the sun until all bruising has subsided. A sunscreen should be used routinely; it is easy to get sunburned during recovery because of temporarily diminished sensation.
Your New Look
Your results will be recognizable almost immediately after liposculpting – especially the first night before the swelling sets in. This will continue to improve gradually as the postsurgical swelling subsides over the first 3-6 weeks. The unwanted and unflattering bulges that prevented you from wearing your favorite styles of clothing will be gone, and you will have a new, slimmer body contour.
With continued attention to a healthy diet, moderate exercise, and a weight management program, your treated areas should look great and retain their sculptured appearance for as long as you maintain your weight. Patients who manage to lose an additional 5-10 pounds after their surgery can make a good result become an exceptional result. If, however, patients gain weight after liposcution, they find that they regain fat in the areas treated in a lumpy, bumpy pattern and that they also gain fat more readily in the areas of their body that were not treated with liposuction.
Our patients find liposuction to be a very satisfying procedure to remove the unwanted areas of fat that just won’t go away no matter how hard they try. Click here to request a consultation with Dr. Filiberto Rodriguez, a double board-certified cosmetic surgeon, and liposculpting specialist. Or, you can call his office to schedule your appointment: 956-687-8346 in the McAllen/Edinburg area or 956-350-6561 in Brownsville. Whether you’re interested in thigh, arm, or stomach liposuction procedures, let us help you get rid of those unwanted bulges that are hiding the “slimmer you” within.
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