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LIPOSUCTION

Introduction

Suction assisted lipectomy or liposuction is one of the most popular means of body contouring techniques in cosmetic surgeries. A number of important modifications to the standard suction assisted liposuction including UAL (ultrasound assisted liposuction), PAL (power assisted liposuction), VASER and laser assisted liposuction are available today.

Prior to liposuction, a pre-operative marking is done with the patient in an erect position. In patients undergoing total body liposuction or contouring, marking can be done one day prior. Areas to be suctioned are marked with a circle.

Incisions are placed in hidden areas and are approximately 3mm to 4mm in length.

Types Of Anaesthesia

Small volume liposuction can be done under local anaesthesia with mild sedation. Large volume liposuctions require general anaesthesia.

The procedure involves injecting anaesthetic solutions into the body to facilitate fat removal and decrease post op pain. Special cannulas are used to aspirate the fat from the problem areas via small incisions.

Post Operative Care

Patients require a compression garment, whichis customized as per area. Patients can be discharged on the same day and can return to normal activities within 3 days.

Light exercises are allowed after a few weeks. Post-operative swelling and bruising occur and subsides over a week to fortnight. Final aesthetic result will be visible within a few months.

FAQ’s

Liposuction is the quickest and easiest way of reducing fat in ‘specific areas’.Simply put, Liposuction is a way to convert or break the body fat into a liquid form, and then drain this liquid out using small suction tubes called micro cannula.

A surgical procedure removes stubborn pockets of fat from agreed-upon areas of the body and remodels those areas to make your overall appearance and body shape more pleasing.

It is worth noting that there is a limit to the extent of fat that can be removed through liposuction. The effects of liposuction are aesthetic, and it is not intended for treatment of obesity.

The procedure is usually performed under local or general anesthesia, depending upon the area being treated. It takes 2-3 hours, and rarely, if ever, is there a need to stay overnight in the hospital.

Regular exercise and healthy eating can help most people achieve a desirable figure or physique. However, for some, losing weight can turn into an unceasing struggle against stubborn pockets of fat that no amount of exercise or diet can eliminate. This is where liposuction, or fat removal surgery, comes in.Regular exercise and healthy eating can help most people achieve a desirable figure or physique. However, for some, losing weight can turn into an unceasing struggle against stubborn pockets of fat that no amount of exercise or diet can eliminate. This is where liposuction, or fat removal surgery, comes in.

So, what is “stubborn fat”?

Some fat cells (“Lipolytic cells”) can easily be broken down. While some are “Antilipolytic cells”, which are very difficult to metabolize, and are considered as secondary reservoirs of fat. It is these fat cells that Liposuction removes.While Liposuction is mostly used for cosmetic & aesthetic purposes, it is sometimes done for medical reasons too, to correct the following conditions or situations:

• Gynecomastia (excessive or abnormal fat accumulation in male breasts)
• Lipomas (benign fatty tumours)
• After excessive weight loss surgery
• Lymphedema – excess fluid collection in tissues – edema
• Lipodystrophy – issues with metabolism of body fat

1. You should be able to walk about shortly after your surgery, once the anesthesia has worn off.
2. The day after surgery, there will be mild pain that is easily controlled with a pain management plan which may include walking and medication.
3. You might also be prescribed antibiotics to control infection risks.
4. In a few days, most patients can resume normal work with minimum discomfort.
5. To speed recovery time, the doctors recommend compression garments.
6. The incision areas will have some liquid dripping off for a few days, this is normal and considered to be good for recovery and healing.
7. Depending on the area treated, the swelling may take up to a few months to fully subside and for the new look to set in.
8. The elasticity of your skin, which depends on your age and genetics, will also play a part in your overall recovery

After recovery, you can expect a shapely and much better contoured body. A good doctor will get your body contoured to the agreed shape. This will match the agreed expectations that were shared between you and the surgeon.

You should schedule regular follow up sessions with your doctor to ensure that the incisions are healing well and swellings are reducing as expected by the surgeon. If you notice any unexpected changes in the treated areas, do get it to the attention of your doctor during your follow up meetings.

The full results of liposuction would be visible within 2-4 months after your surgery, though majority of the effect would be visible soon after the swelling from the surgery subsides within 4-8 weeks.

It is important that you follow the advice given to you, and keep up the diet and exercise regimen. We would not like you to put on weight again after surgery and lose the effects of the liposuction procedure.

Liposuction can treat most areas of the body. You would need to agree with your surgeon which specific areas you want to treat. The following body areas are most commonly treated via liposuction:

• Abdomen / Stomach/ Tummy
• Arms (upper)
• Back
• Buttocks
• Chest
• Chin
• Face
• Flanks (love handles)
• Hips
• Neck
• Thighs
• Waist

You can ask our patient counselor for more details and for before/ after images of our surgeries for any of these areas.

Deciding about Liposuction

Though Liposuction is an extremely common procedure these days, it is nevertheless a surgical procedure which will alter the way you look and feel. Therefore, it is imperative that you are fully ready, both physically and mentally for this surgery. At Cocoona, we ask that you self-evaluate on the following parameters:

• Have I really tried out the other options (diet control & exercises) to reduce the fat in my body?
• Am I seeking to reduce weight by this procedure?
• Have I identified the problem areas that need fat reduction?
• Are my expectations realistic?
• Am I ready for the post Liposuction plan so that I do not put back the lost fat?

After getting clarity on these initial thoughts, the next steps of seeking a good Liposuction surgeon, and clinic are of paramount importance.

The best Liposuction surgeons are ones with lots of experience, fantastic results and reputation, admired by peers and patients, and who will give honest and realistic feedback of what you can and cannot achieve through liposuction.

A good clinic is one which has the best liposuction surgeon, licensed anesthetist, well trained nursing staff, and excellent reputation for successful procedures. At Cocoona, we tick all these boxes.

It is important for the Liposuction candidate to be fully convinced and ready for the change in their body shape before giving the final go-ahead.

Anybody with an accumulation of stubborn fat in specific parts of the body is eligible for Liposuction.

Good liposuction candidates are adults, who are in generally good health, non-smokers, non-pregnant women.

Ideally the person’s weight should be within 30% of the desired range. The best practice is to remove no more than 7% of the body weight during a single procedure (exception is made in certain cases where medical reasons might require larger volumes of fat to be extracted – known as liporeduction.) The elasticity of the skin is also looked at carefully to determine the best method for the candidate. Younger people, or those with good skin elasticity will get better results as their skin adapts to new body contours better and more easily.

People with diabetes, heart ailments, blood circulation problems, or weak immune systems should not proceed with liposuction.

Your liposuction surgeon and clinic should conduct an initial investigation to assess your suitability for liposuction, and set realistic goals for your surgery. This is also the process that we follow here at Cocoona.

Methods of breaking down fat cells

There are three major ways to break down fat cells in the body: by exercise, or by non-surgical methods, or surgical methods. The surgical methods are the ones that fall under the category of Liposuction.

1. Exercise and Diet:It is the bottomline of fat metabolism. Regular exercise and balanced nutrition can help break down fat cells. Most doctors and nutritionist will recommend this as the first step towards losing fat.

2. Non-surgical which means the fat cells are broken down underneath the skin with external energy devices that work using:

• High intensity focused ultrasound (Liposonix Ultrasound)
• Radiofrequency (Thermage)
• Combination devices using laser, infrared light (IR) and bi-polar radio frequency (VelaShape®)
• Injectables such as Phosphatidylcholine (Injection lipolysis)
• Carbon Dioxide insufflation under the skin (Carboxytherapy)
• Cryolipolysis that uses a freezing device (CoolSculpting®/ Zeltiq)

Non-surgical or non-invasive fat or cellulite reduction methods give good results for small problem areas and enable faster recovery. However, they do not provide the same depth of treatment as surgical liposuction. They may also require multiple sessions to provide desired shape and contours.

3. Surgical methods – Clinically speaking, it is the surgical methods that fall under the category of liposuction, and we will look at the various options in the following section.

The traditional liposuction technique involved the mechanical disruption of fat cells, in which the surgeon would shear and extract the fat cells with the aid of a high-power vacuum.

The modern technique of liposuction involves liquefying or emulsifying the fat and then extracting the fat using small tubes or cannulae (microcannula) and a low power suction machine.

You should discuss with your liposuction surgeon the various body contouring options possible, and then decide as to the best course of treatment.

Here at Cocoona, we utilize the latest technology under the expertise of super-specialized surgeons to deliver the best possible results..

There are many different technologies used to perform surgical liposuction, that cause lipolysis and make it easy to remove the fat cells from the body. These are divided into two basic categories – either using non-energy devices, or using energy based devices.

A) Non-Energy devices

1. Vibrolipo (Liposuction assisted by compressed air) – This works on the principle of gentle and continuous movement of inserted tube. The cannula vibrates and its movement helps to break down the fat cells allowing for smooth removal of the fat from the body.
2. Power assisted Liposuction – In this technology also the cannula automatically moves but has more reciprocating movements. The results are similar to the previous method.
3. Water Jet assisted Liposuction (WAL) is fundamentally a newer approach to break down the fat cells yet again, mechanically. Pressurized saline water is used to gently remove the fat cells.
4. Tumescent Liposuction is a simple method in the hands of a skilled surgeon. Here a mixture of anesthetic fluids and fat dissolvers are microscopically injected into the treatment area. This mixture numbs the body part and alsoliquifies the stubborn fat, making it easy for the surgeon to use a vacuum device to drain out the liquids.

All the above technologies have some pros and cons. It is the experience of the surgeon that determines which method will give the best results for the individual patient.

B) Energy based devices:

Heat energy or sound energy devices can also be used to break down the fat cells, thus eliminating the need of physical movement under the skin to emulsify the fat. These technologies make the procedure easier and less tiresome too. Some of the procedures are as follows:

1. Laser Assisted Liposuction (LAL) –In this invasive or surgical technique, various laser devices are used under the skin to emulsify the fat cells and allow easy suction using smaller cannulae and a low power vacuum. The laser energy also helps to cause some skin tightening, giving a better end-result.

It is generally useful for smaller areas requiring smaller volume of liposuction such as chin, neck, arms, small love handles, etc.

2. Radio Frequency Assisted Liposuction (RFAL) –This technique uses a device that consists of two probes working in tandem, one in the form of a small cannula that is used under the skin and an overlying probe that works on the skin surface.

The radiofrequency (Rf) energy is released from the internal cannula and is transmitted though the fat and skin to overlying probe (Bipolar radiofrequency). The continuous wave of Rf energy produces gentle elevation of temperature, that not only melts the fat but also causes skin tightening.

This device is useful if there is large amount of excess skin or the skin tone is very poor. Ideally this is suited for a skin excision procedure such as tummy tuck, arm lift, thigh lift. However, the patient may not want a major surgery to avoid large scars and longer recovery period. In such a situation RFAL is a reasonable alternative.

3. VASER Assisted Liposuction (Vibration Amplification of Sound Energy at Resonance), popularly also known as Ultrasound Aided Liposuction (UAL)

This device uses ultrasound energy that causes fat lipolysis and skin contraction. The device produces high intensity ultrasound energy that causes breakdown of fat cells. It is very useful for tough fibro-fatty tissue, secondary liposuction, large volume abdominal liposuction, and high definition liposuction in men and women.

Liposuction is an excellent option for treating large problem areas and excess fat deposits. It can help improve your body contours in different areas in one-go. However, it has a longer recovery period, higher cost, and risk of complications as it involves surgery.

Deciding upon the best method of liposuction is a decision to be made in close consultation with your surgeon, as each method has its pros and cons. Your surgeon will decide the technique to be used based on your body condition, size & number of problem areas, quantity of fat to be removed, lifestyle factors, skin elasticity and other relevant parameters.

The effects of liposuction are long-lasting. Those fat cells that are removed during liposuction can never come back. Small amounts of weight gain can still maintain your new body contours in the treated areas. However, if a person gains a large amount of weight after liposuction, then new fat cells will grow. There may be more fat accumulation in the untreated body areas where there are greater number of fat cells remaining vis-à-vis the treated areas where fat cells have been removed.

If you do not gain weight post-liposuction, fat will not come back to the treated areas. However, changes related to ageing can yet slightly alter the look of your treated areas.

The cost of Liposuction depends on the following:

Treatment Area – Size and number of areas to be treated and the amount of fat to be removed. So, a simple procedure to just remove the fat from the upper arm will cost much lesser than fat reduction from multiple areas or more difficult areas.

Procedure Used – The type of liposuction technique used also affects the cost. Newer, more sophisticated techniques using laser & ultrasound typically tend to cost more.

Surgeon’s Expertise – The surgeon’s fee is based on their experience. Obviously, a reputed surgeon with an established track record of quality results will charge higher fees.

Clinic/ Hospital – Fees also depend upon the quality of the facility chosen for the operation.

Geographic Area – Depending on the city/ area you decide to have your procedure in, your cost is likely be different. Larger metropolitan cities might cost more.

You should bear in mind that the expertise of your surgeon and your comfort factor with him/ her should be one the most important considerations than simply the cost of the surgery. A cheap liposuction could turn out to be an expensive proposition in the long run.

For an accurate assessment of cost, you would need an initial consultation with our surgeon.

Liposuction recovery period and downtime

Recovery from liposuction varies from a few days to a few weeks depending upon the size of the treated area and method used.

Having the procedure done at with a skilled surgeon with advanced facilities, greatly reduces the recovery period.

Most people can start walking/ moving shortly after the anesthesia wears off. Normal work can be resumed within a few days once the swelling starts to subside. Compression garments are usually prescribed along with medication for faster recovery. Recovery period also depends on your body condition and skin type.

We recommend that working people plan a few days off after surgery to rest and recover before resuming their work. Basic exercises can be resumed within a week after consultation with the doctor.

If you are into heavy sports/ physical activities, your surgeon will advise you on how & when you can resume your active lifestyle.

Modern techniques of liposuction have made the procedure a safer, more comfortable, and less painful experience, which helps faster recovery.

At Cocoona, we employ these latest techniques to ensure your quick recovery.

Preparing for initial meeting with the surgeon

Once you are clear about your reasons for liposuction, have decided to proceed, and are ready to see the shortlisted surgeon, call us to fix an appointment.

On the appointed day, our chosen expert liposuction surgeon will consult with you. During the consultation, you should expect the following:

– Discussion on your need for liposuction, goals, and reasons.
– Understanding your medical history
– Evaluating your health status
– Options available for your liposuction procedure
– Examination & measurement of your body, maybe take some pictures too

Explanation of the surgery options, steps involved, and the future treatment, risks, and potential complications, if any.

A bit of apprehension is natural, but don’t feel shy in discussing any issues that you may have in respect to your new look.

Our next section, gives a list of handy questions that you may want to ask the surgeon. Do read that too. Print out the list and keep it handy so you don’t miss out on asking any questions directly.

Being well informed is being well prepared. Besides checking that your clinic and doctors have the necessary skills, knowledge and experience, here are some more areas that you should probe:

• How many years of experience do you have as a Plastic Surgeon?
• How many liposuction procedures have you done?
• Where will the surgery be conducted?
• Is the clinic prepared and certified to assist liposuction surgeries?
• Do you have a licensed anesthetiston board?
• What are the most common complications that your patients have had? And how were they handled?
• Do you have a “before” and “after” photo album for this procedure?
• Am I a good candidate?
• What can I expect after the surgery?
• What precautions would I need to take pre-surgery and post-surgery?
• How many days will I take to recover fully?
• What should I do for a quick recovery?
• Will the shape and appearance of my body change over time? If yes, how?
• What are the risks involved in this procedure?
• What treatment option/ technique will be used for me?
• Is non-surgical body contouring/ fat reduction an option for me?
• How does liposuction impact pregnancy?