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Patients who could be helped by liposuction:
•Lipomas
•Hyperhidrosis, excess sweating, axilla only
•Pseudo gynacomatia (breast enlargement in males)
This is the liposuction technique or procedure that is now the world
standard. The tumescent technique was developed by dermatologists
for improved surgical safety. This technique eliminates general
anaesthesia, blood transfusions, prolonged post-operative use of
compression garments, and soreness.
The tumescent technique is localized infiltration with saline, lidocaine,
epinephrine, and sodium bicarbonate into the subcutaneous fat. This
anaesthesia is now used for liposuction, dermabrasion, face-lifts,
hair transplants, and other cutaneous surgery.
The areas for liposuction are infiltrated through a fine needle
with the tumescent solution. The area of insertion is previously
anaesthesized with xylocaine.
The injected fluids fill up the spaces between the fat cells. This
loosens the fat cells when the cannulas are inserted, suctioning
is easier. Also the fluid between tissue causes the cannulas to
be well lubricated, allowing less trauma to blood vessels and nerve
endings.
The tumescent anaesthesia fluid contains epinephrine so the blood
vessels are constricted and much less bleeding occurs. Post-operatively
there is less bruising. The loss of blood is negligible and we do
not have to worry about replacement.
Post-operatively the small incision sites where cannulas are inserted
are left open. Approximately 20% of the tumescent fluid will flow
out through these areas. What you see will be blood tinged fluid.
There is really less than 1% blood. The fluid may drain for two
days and the small incisions will close by themselves. Sutures are
not necessary.
External application of an ultrasonic machine may be used to loosen
up the fat cells even more, so that there is greater ease in sucking
out fat cells.
The duration of the surgery depends on the areas or sites to be
done. The patient is awake throughout the surgery as anaesthesia
is tumescent and localized. Post-operatively, the patient may be
slightly groggy because of sedation. There will be supportive garments
worn over the operative sites. Sponges will also be used to absorb
the tumescent fluids.
The supportive garments should be worn at least six weeks and longer
if larger volumes are removed.
Vigorous exercise should be avoided for the first three weeks but
we do encourage daily walking. Return to work, if it does not involve
physical labour, could be within one week. Earlier return is possible
if the patient feels well.
The first week post-operatively, the patient will notice the skin
is numb over the affected areas. This is because of the anaesthesia
and also the damage to the nerves when liposuction is done. There
is also damage to the blood vessels so there will be bruising. Tapping
or pressing on the area will result in discomfort like that of pressing
on a big bruise. You will be given a prescription for an analgesic
but generally pain is not experienced, just discomfort.
There may also be some swelling seen and no reduction in contour
is evident for a few weeks. If the neck is done, the jowls may swell
and you may want to stay away from work for a few days in spite
of feeling well. The final improvement may take weeks to evolve.
You must be patient. The abdominal wall sometimes feels”woody”
because the healing areas are so firm and thickened. These effects
will go after a few weeks.
Photographs are taken pre-operatively and also in six weeks post-operatively
and again six months post-operatively. They will be part of your
record. They may also be used for teaching purposes and, if so,
your face will not be shown.
Today, Liposuction involves small cannulas being inserted. You may
notice marks that are 1/4” long. We try to place them at body
creases so that they are not noticeable. Usually they are red and
may be darker initially but you can apply Vitamin A acid creams
to help the appearance. Even if nothing is applied, after 6 to 12
months they are less prominent. We cannot really predict the final
result as it varies from person to person.
Serious complications are rare but with breakage of skin there is
always the risk of infection. Sometimes there is seroma, which is
a collection of serum or a pocket of fluid but this can be drained.
Sometimes there are untoward or idiosyncratic reactions to the medications.
This is totally unpredictable.
The most common problems are:
1. Bruising - may last two to six weeks depending on the area and
the extent of the surgery.
2. Numbness - the skin nerve endings may take weeks or months to
recover.
3. Tenderness or Discomfort - recovering skin may itch and be tender
when probed.
4. Contour Irregularities - this is usually temporary. Perfect symmetry
is the goal but slight differences may be seen and irregularities
in the skin of older patients is common..
5. Bleeding or Oozing - bleeding is rare but pink tinged oozing
of the tumescent fluid in the first 24 to 48 hours is common.
Conditions when patients should not have liposuction:
• Poor wound healing
• Poor general health
• Poor clotting ability or bleeding disorders
For a printable .pdf file with Pre & Post
Operative information, click on the links below:
• Pre-Operative
info for Liposuction/Liposculpture •
• Post-Operative
info for Liposuction/Liposculpture •
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