Liposuction
Liposuction is an extremely common cosmetic procedure in the United States ranking among the most common cosmetic procedure performed. Liposuction is also a very common procedure in my practice. There are many reasons why a patient chooses to undergo liposuction. The most common reason and often the most effective indication for the procedure are localized deposits of fat despite regular exercise and proper diet. These are the so called “problem areas” that despite tight diet and exercise it is hard for us to get rid of the fat in these areas or when we do so it is only transiently. These areas are commonly the “submental” fat deposit in the neck, the “bra fat” area that hangs above the back of the bra line, the “love handle” on the abdominal flanks, the “muffin top” over the front of the cut-off jean shorts, or simply the layer of padding on top of the abdominal “six-pack”. In these areas, with extremely strict diet and exercise for months and yielding a good result, only a weekend of pizza, pasta, and French fries is enough to undo months’ worth of hard work. If this scenario describes your issues, then liposuction will be very helpful to you.
The other group of patients who will seek out liposuction are breast cancer patients who have estrogen positive tumors. These women will often be prescribed an estrogen receptor blocking medication to treat and prevent recurrence of their cancer. The estrogen blocking medication can unfortunately cause weight gain and other symptoms which can often make patients feel uncomfortable. In these women despite diet and exercise, the weight gain accumulates, and extreme frustration can occur. These patients often undergo liposuction of the posterior trunk, flanks, and anterior abdomen, this is called “circumferential” liposuction. These patients often have profound improvements in weight loss, loss of inches, and overall improvement in body contour. They find a new confidence and happiness in their body shape and appearance, and often get a kickstart back to the gym, running, or spin class.
The next group of patients who undergo liposuction are patients who are attempting to lose weight and seem to have reached a plateau in their weight loss regimen. Patients who are losing weight in anticipation of abdominoplasty fall into this category. In many patients their skin may have lost elasticity and liposuction will result in a loss of inches on the body frame. The loss of inches may occur in skin with stretch marks that had lost its elasticity and after liposuction the skin becomes even more wrinkled. In these cases, patients may not mind the wrinkled skin as they appear better in clothes, or the liposuction and excess skin is just a bridge to an abdominoplasty or other skin excision on the body part. During this staged weight loss patients are undergoing diet and exercise programs to continue to lose weight and improve their overall health.
Liposuction is a procedure with a high patient satisfaction rate, and I enjoy having happy patients. If you are interested in undergoing liposuction, please contact our office and one of my friendly staff will be happy to assist you.
The office phone number is 949-612-8632. If you would like to learn more about liposuction and see before and after results, please click on the blog section for more information.
Liposuction Frequently Asked Questions
Liposuction has been a tool in my practice for both cosmetic and reconstructive cases. I perform liposuction on a daily basis in one part of the body or another either for aesthetic purposes or for reconstructive procedures on the breast for breast cancer. I most commonly use standard liposuction with a varying degree of tumescent solution injected per area of the body depending upon the location operated on and the amount of fat anticipated to be removed. Almost 100 percent of my liposuction cases are performed under a general anesthesia with the patient completely asleep. While the tumescent fluid does contain local anesthetic, most patients are comfortable being completely asleep during the procedure. The more comfortable you are during the procedure, the more complete and thorough I can be with your procedure, and I can provide you with the best result possible. In general, the complications from liposuction are very low. The most common complications can be related to the access point of the cannula which can include hypertrophic scarring. This is related to the motion of the cannula through the skin. We do our best to reduce the friction of the canula through the skin, but occasionally these scars can become keloid or hypertrophic. If that is the case, these scars can be revised in the future.
Swelling and bruising are common after liposuction and may cause some discomfort after your procedure. However, your ability to return to work and other activities will be determined by how many areas of the body you elected to have liposuction. Recovery time will vary from patient to patient. After surgery, we will place you in some form of compression wrap. This can be an abdominal binder or compression garment around your trunk or ACE bandage wraps or compression garments around your arms and legs. Compliance with the compression wraps can help reduce your swelling and help control your pain post-operatively.
The pain after liposuction is very tolerable. In general, patients will be on pain medication for about 3-4 days post-operatively. If you were to have surgery on a Friday you would likely require pain medications Friday night, Saturday, Sunday, and by Monday you would likey be fine reducing the amount of pain medicine. Most patients receive Percocet for pain after the procedure, Vicodin is possible too if you have taken Vicodin before for a different procedure and have not experienced any nausea. Many of the narcotic pain medications can produce nausea and we try to select one for you that does not cause nausea. After the 3 days it is quite common for patients to switch to Tylenol and Motrin during the day and save the narcotic pain medication for the night-time.
During liposuction, the canula is passed in the subcutaneous tissue and fat is removed from this space. Provided there is not another procedure performed with the liposuction such as breast augmentation, then after one week of recovery, you can return to the gym. In fact, this is encouraged. After liposuction a compression garment is worn day and night for two weeks and then nighttime for two weeks. Even though liposuction is traditionally small incisions beneath the skin, a lot of trauma is created beneath the skin. The energy your body consumes healing this area causes an increase in your metabolic rate and you continue to lose weight while you are healing.
As you return to the gym or cardiovascular exercise in your second week of recovery, a modest amount of pain is normal. This tends to improve significantly over the next several weeks.
Liposuction is performed under a general anesthetic. During the general anesthesia, a solution containing saline, lidocaine, and epinephrine is injected into the subcutaneous tissue. The normal saline increases the turgor and surface area of the fat, the epinephrine constricts the blood vessels to reduce bleeding, and the lidocaine provides pain relief. After we wait for the epinephrine and lidocaine to take effect, we clean your skin with an antiseptic scrub.
Small incisions are then made to place suction cannulas to remove the fat beneath the skin. After we remove the fat from beneath the skin, we then close the incisions made in the skin with absorbable sutures, and then place a compression garment around the area that underwent the procedure.
At the end of the procedure, you are brought to the recovery room where nurses will monitor your recovery. After about one hour in the recovery room, you will be discharged home or depending upon the amount of volume removed, you may stay overnight one night in the surgery center. At night when you go home, it is important to place old blankets or sheets on your bed or couch as the tumescent fluid we inject will start to leak out of your incisions at night. The fluid is often “blood tinged”. We prefer to see you in the next 24-48 hours in the office or I will contact you by phone.
Tumescent liposuction involves poking tiny holes in the skin through which a straw-like microcannulae, only an eighth of an inch in diameter, will be placed. Some of the major benefits are that anesthesia is not required, stitches are not needed and, only tiny scars remain. Additionally, patients heal rapidly and experience very little discomfort. We will discuss which liposuction procedure is appropriate for you during our consultations.
While I enjoy every facet of my practice, I have found that liposuction is a very powerful tool whether used alone or in conjunction with other aesthetic procedures. For example, many patients who come in in for breast augmentations also choose to have liposuction performed on the localized fat deposits beneath their chin or neck. A woman who wants to have a rhinoplasty performed will many times elect to also have the fat removed from beneath her chin or neck.
Many women share one common frustration – stubborn fat on the back of the upper arm and bra line that is resistant to diet and exercise. Liposuction of the upper arm and bra fat can be very rewarding to the patient who is the right candidate. Significant changes after liposuction can be readily seen within 4 weeks post-operative and continue to improve over many months, stabilizing at one year but continuing to improve for upwards of two years or more depending upon diet and exercise habits. Liposuction is an excellent adjunct to breast augmentation, breast lifts, rhinoplasty, and abdominoplasty.
These types of combination procedures are very effective when performed in the same aesthetic region, such as the rhinoplasty and neck/chin liposuction or the breast lift with liposuction of the bra fat.
The decision to have liposuction is not to be taken lightly and should be made with the help of a doctor. Before you decide to have liposuction, it is highly recommended that you have a consultation with us to discuss your goals and the details of liposuction procedures. We will spend time with you during the consultation listening to your concerns. We encourage you to call us after your consultation if you have more questions or please feel free to come in for a second consultation. Many questions are answered at your pre-operative appointment if you would like to save your questions for then. Prior to liposuction we send patients for blood work, which consists of a CBC + platelets, Chemistry, PT/PTT/INR and then if you are over 50 you might also be required to have an EKG completed or cardiac consultation.
If you decide to move forward with liposuction after your initial consultation, you can schedule your pre-operative appointment and procedure. Our facility is located in Newport Beach, making it convenient for the follow up appointments. After your procedure, follow up is necessary to prevent complications and ensure the best results. Your satisfaction can only be achieved if your liposuction is both safe and effective. This is my primary objective.
