LIPOSUCTION (adipoaspiration) is a procedure that removes body fat by aspiration.
Today liposuction is one of the most frequently used technique in plastic surgery. The method is safe and efficient due to the important improvements and innovations, such as wetting solutions, cannulas of various size and shapes as well as new technologies like ultrasound liposuction (UAL) in PAL liposuction.
The method is used to remove localized fat deposit – LFD, from the specific areas of the body such as ‘’ riding breeches ‘’, lower abdomen, inner tights, knees, hips, buttocks etc. or to model and make circumferential body contouring.
Optimal body contouring with liposuction can be achieved with proper patient selection. Liposuction is generally performed in healthy patients who maintain realistic goals and expectations.
There are various techniques of liposuction:
- SAL liposuction (suction-assisted lipoplasty) – traditional liposuction. Cannula is connected with the liposuction device that produces vacuum of one atmosphere and sucks out the fat tissue. Cannulas have smooth surface with one or more holes of different lengths and size. The technique is easy to use, has been performed in years and it gives positive results. It requires some additional effort and is more difficult to execute in dense fibrous tissue. If we use cannulas with cogs, then we talk about fat disruption technique (Mangubat). The cannula literary grounds the fat tissue and then sucks it out.
- PAL liposuction (power-assisted lipoplasty) – a special handle is connected to the device that generates up to 6,000 cycles/min and shifts the cannula 2-4 mm back and forth. This allows the cannula to move through the tissue easier and mimics the movements typically made by the surgeon. Then the fat is aspirated in the same way as in the traditional liposuction. As the PAL cannula can easily break the fat in the connective tissue, the procedure itself is quite fast and therefore less physically demanding for the surgeon than the SAL technique.
- UAL liposuction (ultrasound liposuction or ultrasound-assisted lipoplasty) – the special titanium probe transmits ultrasound energy into the tissue and selectively dissolves fat cells through the process called cavitation. Thus obtained emulsified fat is then aspirated and the tissue is contoured in the same way as is done with SAL technique. This method provides for evenly contouring of fat tissue by using a simple technique. It is necessary to protect the incision sites because of the higher temperature surrounding the probe.
- LIPOSCULPTURE – this is the only method of liposuction that does not require aspirator but a disposable syringe. Inside the syringe we can produce a vacuum, which afterwards enables the fat suction. We can then inject the obtained fat as a tissue filler to correct lines and wrinkles, skin irregularities, depressions, cellulite etc. during the same session. It is a very useful technique and is less physically demanding compared to the regular liposuction. We are all extremely grateful to Pierre Fournier and Luiz S. Toledo for introducing this particular method!
Which technology to use is purely the surgeon’s preference. We use all methods at our clinic with the exception of PAL liposuction,
Each liposuction can be followed by various side effects – bleedings and hematoma, infections, pain, heath injuries, seroma, change of pigmentation and skin sensitiveness, skin irregularities and so on. How frequent are the unwanted side effects depends to the great extent on surgeon’s experience, chosen method and cannulas he used for adipoaspiration. Thanks to various formulations of wetting solutions, which could contain even adrenalin, it is possible to achieve a beautifully sculptured body with the minimal blood loss and pain.
All our patients are operated under the local anaesthesia with or without i.v. sedation. The patient does not feel any pain and he or she could observe the procedure. After the procedure, the patient can move freely and go home. The recuperation takes minimum time so there is no major downtime.
I warmly recommend all patients, who decide to undergo liposuction, to change their diet, physical activity habits and their life style. Then the success of the operation is absolutely guaranteed.
The following lines are the written form of the instructions your surgeon has already given you at the first consultation. Our experience has taught us that certain advices need to be repeated several times.
PAIN
varies from person to person. Generally, the pain is minimal and it is strongest a day or two after the procedure. During that period, Aspirin and similar drugs are not allowed, as they contain acetyl salicylic acid (acisal, acetysal etc.) and may lead to excessive bleeding during and after surgery. You can take Lekadol, Panadon, Ketonal etc. Cooling compressions (e.g. bags with gel of different size) will help you to fight pain or swellings.
BRUISING
may occur but are mostly quite mild. They can appear bellow the operated site because of the gravity. They disappear within several days.
COMPRESSION GARMENTS
are of extreme importance during this period. We use them to reduce accumulation of blood and lymph in the treated area. If the area is bigger, more time for resorptions is needed and one will have to wait a little longer to see the results, than normally.
Compression pants, belts and the likes need to be regularly monitored and tightened when needed, as the swelling is smaller each day and the healing process is getting on. Compression (pressure) must not be too strong, as the oedema can show up bellow the compression site.
One has to wear compression garments for a month on average, during both the day and night. Taking showers is allowed and highly recommended.
We advise older patients and those that have undergone a more aggressive UAL liposuction (due to the bigger area or quantity) to wear compression garments longer than a month, but only during the day.
MANUAL MASSAGE
is very important and recommended twice a week during the first month. Massage should start immediately after the sutures are removed. Massage should become stronger gradually. Manual massage helps the process of recovery, getting the right skin tonus and it gets achieving the final results sooner. After the knee procedures there could be certain sensitive spots and a regular massage could help a lot.
PHYSICAL ACTIVITIES
are desirable. They help and accelerate the healing process and shaping of the body. Skin and its lower layers get the right tonus and colouring.
RIGHT DIET
among other things, mean getting and maintaining optimal weight. We know how various diets and fast weight-loss programmes can be confusing.
We are happy to offer you a so called Weight-loss School or the healthy diet. It comprises 4-5 hours of individual consulting (what, when, how and why). We are absolutely positive we can offer you only the best, without any kind of drastic sacrificing or calorie counts.
REGULAR CHECK-UPS
are free one, three and six months after the procedure.
Ultrasound liposuction (UAL) is a surgical procedure done under a local anaesthesia with peroral, intravenous or intramuscular sedation.
Our experience tells us to advise our patients to come to the surgery well rested after a good night’s sleep and without any breakfast. We advise against consuming coffee and large quantities of other beverages to prevent excessive urination, which can make patient uncomfortable during the procedure.
UAL liposuction is a mild surgical procedure and therefore the patient needs to be relaxed and not afraid. Fear makes surgeon’s work more difficult and could provoke pain in an otherwise sedated patient. If a patient is not relaxed but tense, the anaesthesia does not work, as it should. So, leave your fears at home.
We recommend that patients do not take any pills that contain acetylsalicylic acid (Aspirin, Acisal, etc.), use too much vitamin E or consume a lot of garlic two weeks prior to the procedure. All of the listed items can influence coagulation and the possibility of excessive bleeding during the procedure increases. If there is a need to use painkillers after the procedure, we recommend ibuprofen/paracetamol preparations (Bonifen, Lekadol, Panadon, Naklofen etc.).
After the surgical procedure the small incisions, that were used to instil anaesthetic fluid, selectively break and suck out fat cells, are covered with sterile gauze and cotton pads that can absorb thin blood-tinged discharge. Incisions are rarely sutured. If the cotton pads get soaked, the patient can change them himself or use a towel. The discharge of body fluids stops a day after the procedure and when it stops, the patient can apply waterproof patches (Opsite). The patients can take showers shortly afterward. The patches are removed after a week, as the incisions are already healed by then.
Immediately after the procedure, we recommend patients to go for a walk. Generally, the day after the procedure, the patient can assume his/her daily routine.
Regarding the compression garments, we assume you monitor the compression and tighten the garments yourself when needed. It is very important as it prevents hematoma, which could impede the healing process and achieving good results. One needs to wear compression garments for at least a month after the procedure.
As already stated it is possible to take showers and have a bath already a day following the procedure.
Seven to ten days after the procedure, we recommend manual massage (twice a week), if possible. Massage helps improve general blood circulation of the treated areas, speeds skin tightening and tissue healing.
It is acceptable to use solarium if there are no bruises.
Post-operative state is not the final one. The final result is gained 3-6 months after the procedure. Even more, the skin keeps tightening after that period!
DOUBLE CHIN
Standard compressive garment should ‘’lift’’ and remold the chin. It should be worn day and night for the first week and during the night only during the second week in patients between the ages of 20 and 30 years. A factor of one week is added for each additional 10 years of age.