Liposuction & Liposculpture
Liposuction (or liposculpture) is a technique that allows vacuuming to remove excess fat in the subcutaneous tissue. It is only effective if there is too much laxity of the skin. Because the fat cells are perennial and therefore are not renewed by your body, there will be a lasting change in your body shape, especially if you continue to maintain a healthy diet and a healthy weight after surgery.
The elimination of the appearance of “orange peel” typical of “cellulite” is NOT a purpose of this paper!
Liposuction is not a dell ‘obesity treatment, but can be associated to the treatments that are used for this. The best candidates are people of normal weight with skin toned and elastic, which have localized fat deposits in certain body areas
Preparing to intervention
The surgery should not be performed in pregnant or breast-feeding and it is preferable, but not required, to avoid the ‘age of menstruation.
They should not be taken for two weeks prior to surgery or medications containing aspirin or acetylsalicylic acid, as well as taking oral anticoagulants should be adequately replaced with low molecular weight heparins agreeing everything with the patient’s GP. A month before the ‘intervention must be suspended progestogen therapy (birth control pills) in patients who use it: this to further decrease the risk of deep vein thrombosis in the legs.
If you smoke should stop for a least one week before surgery to reduce the likelihood of post-operative complications.
And it recommended getting right now a band or elastic compression stockings to the treated areas.
The night before must be done carefully cleaning shower, shaved with a razor completely the region to be treated, removed the nail polish for hands and feet. Observe the fast of at least 8 hours before the intervention.
The surgery is performed under local anesthesia with sedation or local-regional or general anesthesia depending on the case and the areas to be treated, and usually stays in the hospital for one or two nights. It takes 1 to 2 hours depending of ‘extension of the areas to be treated.
The areas to be treated are first infiltrated with a mix of tumescent solution of saline, local anesthetic and epinephrine in the treatment area. This helps to reduce bleeding, bruising and swelling and makes it easier to remove the fat cells. It will be made a tiny hole in a hidden area of your skin and will place a thin metal tube (cannula). The cannula is connected to a vacuum pump or a syringe that sucks the fat and the fluid. In selected cases, the ‘aspiration is preceded by a break with ultrasound of fat cells, again to facilitate its’ aspiration.
Millimeter incisions are sutured at the end of intervention and applies a compressive dressing modestly through compression straps – mitigation.
During the first hours after the trip will occur loss of mixed fluid infiltration in blood from small holes in the skin, not to worry.
You may feel a slight pain, swelling, discomfort and soreness in the ‘area treated: it is easily kept at bay with standard analgesics and in any case will regress within a few days. If the pain may arise suddenly and accompanied by sudden swelling you must immediately inform your surgeon for a possible development of hematoma.
During the first week and sometimes ten days, they will develop swelling and bruising not only at the level of the treated areas, but also in the neighboring ones by gravity. They are physiological and subside spontaneously. Similarly, data may lead to hardening of scar tissue, that are fixed too ‘them within two months and that can also be treated with lymphatic drainage massage on indications of the Surgeon.
The few and tiny sutures are removed after 7 days. At this point you can make your first shower and get back to work.
You must wear the elastic compression day and night period within 3 weeks after surgery to control the swelling and support the tissues while they settle into their new shape and to decrease the risk of complications. It still can be removed during washing and bathing.
For the first 1-7 days after the ‘intervention is recommended rest; the variability of the period will depend still from ‘extension of body areas treated.
In any case, it is shown a rapid recovery of gait, especially to open air, as it promotes the re-absorption of swelling and decreases the probability of forming blood clots in the leg veins. The stationing in an upright position without walking is rather to avoid.
For about a month it should be avoided any type of sports activity, exposure to sun or heat (sauna, sun lamps, etc.).
For a few months there will be some reduction in skin sensitivity on the area treated.
As with any surgery, albeit modest and performed on patients in good health, you may encounter:
A modest bleeding wound is normal. If important entities can rarely request a ‘blood transfusion.
wound infection. It is manifested by pain, swelling, warmth and redness of the skin, whether or not accompanied by fever. Any infection can usually be treated with antibiotics and local wound dressings, but may result in poor quality scars.
The appearance of a hematoma in the first hours after surgery is rare and is treated with immediate or suction drain. It is manifested by severe pain and sudden increase in volume and hardness that must be reported immediately to the surgeon, as well as bruising on the overlying skin in the following days. If modest it reabsorbed spontaneously. If larger may require the evacuation also through ‘evacuation in the operating room.
The formation of seromas consists in ‘accumulation of a yellow and transparent liquid called serum, entirely similar to that which forms in blisters and bubbles of burn victims. Small amounts are absorbed spontaneously, while more substantial collections may require ‘vacuum as in the case of major hematoma.
Skin necrosis is very rare. Usually heals with outpatient medication; It may require a new suture to improve the scar. And ‘more common in diabetics, smokers and obese.
Rare but more frequent than in other interventions of Plastic Surgery are phlebitis and pulmonary embolism: the ‘incidence increases if the patient is not mobilized early. In patients with risk factors and large areas treated it will be prescribed antithrombotic prophylaxis with low molecular weight heparin subcutaneously for at least two weeks.
Persistent swelling especially if the legs can be treated, but resolves spontaneously or with lymph drainage within 2 or 3 months.
Undulations, asymmetries and irregularities on the modest skin are relatively frequent, especially in lipoaspirazioni most important and due to scar retraction phenomena in the subcutaneous tissue layer.
The improvement effect is immediately evident, although the final result should be evaluated after six months, as well as any “tweaks” in the case of adiposity conspicuous, asymmetries and debris buildup.
The reduction of sensitivity of the treated areas regress spontaneously in a few months.
It must be said that liposuction does not correct the skin orange peel and any depressions subcutaneous tissue. It also does not stop the normal aging process, so it is inevitable that with age the skin relax or determine a new increase in size with weight gain. In this case even if the number of fat cells is decreased, the remaining ones can still increase in size. However, even without subsequent retouching, the appearance of the treated areas will still be better and with less weight gain than you would if the ‘intervention had not been executed!
Inevitably the intervention produces permanent scarring although millimeter, well hidden and which improve over time. In addition some patients, due to excessive skin reactivity can develop reddened scars, enlarged or hypertrophic and therefore easily visible. They are treatable by surgery or require revision surgery after one year.
Small irregularities and undulations of the skin surface are possible.