If you're considering liposuction ... For generations, people have used various techniques to improve their physical appearance. Although diet, exercise and flattering clothing styles help many look better, others remain dissatisfied because of stubborn, unsightly bulges. In women, those fat deposits occur most frequently from the waist down, on hips, buttocks and outer thighs ("saddlebags"). Fat deposits on men tend to accumulate above the waist, on the abdomen and sides of the waist ("love handles").

Several years ago, a new procedure, liposuction surgery, was perfected by a French physician. The procedure allows both men and women to improve the contours of their bodies through this relatively simple and safe technique. Liposuction surgery involves the removal of fat cells from the body and may be used alone or in conjunction with other procedures, such as facelift or "tummy tuck". It is designed for those who have specific areas of localized fat deposits who have tried unsuccessfully to eliminate them through diet, exercise and weight loss. While the procedure is not designed to correct general obesity, any area where excess fat deposits have accumulated can be treated. These include the chin, neck, jowls, cheeks, arms, inner and outer thighs, buttocks, knees, hips and abdomen. Men with gynecomastia (enlarged breasts) can also benefit from this technique.

The best candidates for lipsuction...

Men and women in good physical condition with good skin elasticity are the best candidates for this surgery. When the procedure was first introduced, only younger people were considered to be good candidates: however, recent improvements in the technique have made it possible to treat patients of all ages. Each person seeking this treatment, regardless of age, must be personally assessed by the physician to determine if he or she is suitable for liposuction surgery The best candidates for liposuction are of relatively normal weight but have pockets of excess fat in particular areas. You should be physically healthy, psychologically stable, and realistic in your expectations. Most important, having firm, elastic skin will result in a better final contour. (Hanging skin won't reshape to your body's new contours, and may require an additional procedure to surgically remove the excess skin. This procedure will leave visible scars.) Suction lipectomy is not recommended if you've had recent surgery on the spot to be sculpted, if you have poor blood circulation in that area, or if you have heart or lung disease. You should also understand that liposuction by itself will not improve the dimples skin known as cellulite, though some plastic surgeons offer other techniques that may improve this condition.

Before Surgery...

Prior to surgery a complete medical history is taken in order to evaluate the general health of the patient. A thorough examination is also conducted. The physician describes the type of anesthesia to be used, the procedure, what results might realistically be expected, and possible risks and complications. Preoperative directions may include the elimination of certain drugs which contain aspirin in order to minimize the possibility of excess bleeding. Antibiotics may be prescribed prior to surgery to prevent infection. Photographs are often taken before and after surgery in order to evaluate the final results. The areas to be contoured are marked with a special marking pen.

The Procedure...

Liposuction surgery can be performed in the physician's office, an outpatient surgical facility or a hospital, depending on the physician's and the patient's preference. It can be done under general anesthesia with the patient asleep or under local anesthesia in which the area is numbed and the patient remains awake. Premedication is administered to help the patient relax.

	Dr. Washak begins by making a small incision in the skin and inserts deep into the fat a tube (cannula) attached to a high pressure vacuum suction. The fat is loosened from surrounding tissue by moving the tube back and forth and is then removed from the body with the suction device. The physician determines the amount of fat to remove by feeling the skin and pinching the tissue.
After the incisions are closed, a compression dressing or bandage is applied to the area to prevent bleeding, reduce swelling, and support the affected area. The procedure can last from thirty minutes to several hours depending upon the amount of fat removed.

After Your Surgery...

The dressing remains in place for seven to ten days depending upon the extent of the surgery and the individual's healing process. A surgical compression garment may also be worn. Because liposuction surgery does not involve large incisions and extensive cutting, pain is minimal to moderate an is controlled with oral medication. Antibiotics may be prescribed to prevent infection. Most patients are completely ambulatory immediately following surgery, but rest is recommended for the initial post-operative period. Patients are usually able to return to normal activities within a week although vigorous physical activity is discouraged for several weeks. Some swelling and discoloration can occur but usually disappear within a month. Scars, which fade significantly with time, are, for the most part, inconspicuous because they are made within the natural creases of the body whenever possible.

All Surgery Carries Some Uncertainties & Risks...

Complications connected with this surgery are rare; however, an uneven skin surface, bleeding, infection, numbness and discoloration can occur. Some of these conditions correct themselves in time; others respond to medications. There are certain inherent risks connected with every surgical procedure which should be discussed with the physician. Patients can minimize complications by carefully following directions given by the physician.

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Copyright © 1997 Dr. Ronald V. Washak

Artwork (Lucretia) courtesy of The Gallery of Manrico Orlandi