Lipo Contouring

Lipo Contouring (liposuction) is defined as removal of fat deposits beneath the skin with vacuum assistance. Using small stainless steel hollow tubes with special tips, fat can be removed to improve the shape and appearance of many body areas including upper and lower abdomen, chin, flanks, back, chest, inner and outer thighs and hips.
Liposuction destroys fat cells that will not grow back. They can be replaced, however, by a substantial weight gain. Liposuction is not a substitute for a reasonable diet and regular exercise. Generally, healthier lifestyles and a steady weight help retain the effects of fat loss from liposuction for a long period of time. It is not effective for cellulite, the dimpled condition found in the buttocks, hips and backs of thighs.

What to Expect

Liposuction is typically performed in an office or hospital operating room under general or local anesthesia depending on the area to be treated. After the procedure you will experience minor discomfort, bruising and swelling. It is natural to experience swelling and fluid retention in the area that has been treated. The swelling may take a period of weeks to fully subside. To minimize swelling and help the skin contract, patients wear a garment to compress the operative site for a month after surgery.

Risks and Possible Complications

The risks of liposuction include poor or uneven contour, rippled or saggy skin, irregular skin pigmentation, skin or nerve damage, or excess scarring.

More severe complications which are rare when liposuction is performed safely include, blood or fat clots, severe bleeding, organ damage and cardiac and pulmonary complications.

The use of ultrasound-assisted technology can sometimes result in heat related damage or lingering pain. You may see a change in skin coloration or feel a change in sensation around the area that has been treated. This usually improves over time.

There are several different techniques. In general, we prefer a rapid recovery technique using intravenous sedation (twilight sleep) and local anesthesia. This technique uses tumescent (larger volumes of diluted anesthesia infused into the fat) and we feel this is the best alternative for our patients, as it is associated with fewer complications. It is considered the safest form liposuction surgery and provides extended duration of pain relief following surgery to the point where many patients require little use of pain-controlling medication post op.

Depending on the amount of anxiety a patient has, in some patients heavy IV sedation is necessary, administered by a CRNA.

All forms of laser assisted ultrasonic liposuction result in the creation of fat tunnels within tissue. Post-operatively, compression garments help collapse these tunnels to improve contour and shape.

For liposuction, the areas to be reshaped are identified and marked. Small (nick) incisions are made allowing access for the fat cannulas. Then tumescent fluid is used to anesthetize and saturate the tissue. Cannulas are then passed through the tissue at different tissue levels in a cross-hatched fashion. After the procedure, a single stitch is placed in the incisions and a garment is placed over the treated areas.

Afterwards, you will have some fluid drain from these sites for the first 8 to 12 hours. The garment should be worn as continuously as possible for 10 to 14 days. Typically, patients experience minimal pain and may return to work within 24 to 48 hours.

Pre-Operative Instructions

1. Please see the enclosed medication list with respect to avoiding medications that can contribute to bleeding particularly including aspirin.
2. Smoking should be discontinued prior to surgery and for at least two weeks after surgery as it decreases healing and oxygenation.
3. Please shower the morning of surgery. Do not use conditioner on your hair.
4. You may have a light non-fat meal at least eight hours prior to surgery, if you desire. Otherwise, do not eat or drink after midnight the day before surgery.
5. Wear loose fitting clothes over a black or dark colored jog top which will be worn during the surgery and may be soiled. Old sweatshirts and sweatpants are preferred because of possible drainage that can occur post-operatively.
6. A friend or family member should be with you to bring you to the office and drive you home afterwards. Plan to be in the office from one to five hours depending on the amount of area that is involved. You will not be allowed to drive home if you have had any type of sedation during surgery.
7. Please be sure you have met any financial obligations if your surgery is elective cosmetic surgery not covered by insurance, or refractive surgery. Payment is expected in full five days prior to surgery, unless your insurance covers your procedure. System Optics/Cosmetic Surgical Arts accepts cash, Mastercard, VISA, Discover, bank checks or money orders. NO PERSONAL CHECKS WILL BE ACCEPTED.
8. Pre-operatively, if you have questions please call the office between 9:00 am and 5:00 pm during the week. Post-operatively, you may call the doctor on call at any time.
9. Bring all medications you take with you on the day of surgery for us to verify.
10. Normally, you may take blood pressure medications and heart medications (except Coumadin) the morning of surgery with a sip of water. Taking your blood pressure and heart medication will help with surgery.
11. Please do not wear any makeup, and remove all nail polish.
12. On the day of surgery, bring with you one heavy duty garbage bag and one old large towel.
13. Men may wish to shave their chest or abdomen if this is an area to be operated on and is excessively hairy. It is not necessary to shave areas of light hair growth.
14. Please take all prescribed medication after surgery as directed, until gone.

Post-Operative Instructions

1. Drainage does occur post-operatively following liposuction surgery. Your compression garment may develop blood stains around the incision sites. Abdomens particularly tend to ooze a pink drainage for several hours or days after the procedure. Even though the fluid is reddish in color it is approximately 1% blood with the remainder being the locally injected fluids as well as the tissue fluids. Drainage for each patient will vary from mild to excessive. You might have to change your dressings the night of surgery and periodically for up to 4 days. Maxi-pads may be used for excessive drainage around the incision sites in place of the gauze pads. As drainage subsides, use mini-pads and thin Band-Aids.
2. Nausea and/or vomiting is probably due to the antibiotic or pain medications. It may be minimized by taking the medications with food. If you are vomiting for more than four hours or significantly nauseated, please call the office regardless of the time.
3. It is very important to have someone stay with you the day of the surgery.
4. Your garments should be left on until the day after surgery. At that time all the dressings over the incisions may be removed. If foam has been placed over the areas that have been suctioned, you may still remove the gauze bandages over the incisions; however, the foam must remain in place up to 5 days unless you are allergic to the foam. Baths, showers or hot tubs are not allowed until the foam and stitches are removed at approximately 5 days after surgery. Sponge baths and taking the garment off only to launder it during the first week are recommended. The garment should be worn 24 hours a day for the first week and 12 hours a day for the second week. Wear garment as many weeks as possible. The only areas in which we apply foam are the saddlebags and abdomen. If you really need to shower, foam can be dried by using hair blow dryer. When taking off foam, mineral oil may be applied to skin to help removal.
5. You should have received a prescription for an antibiotic that you are to take until the entire medication is utilized.
6. Do not take any of the over-the-counter medications that are used for pain other than Tylenol for 3-4 days.
7. You may eat as you desire. Fluids are encouraged.
8. Post-operative discomfort usually is in the form of deep muscle soreness and usually improved up to the following week. You may take medications as indicated.
9. Over-the-counter antibiotic ointment may be applied to the incisional areas and may be covered with a band-aid.
10. Activities. You may rest for the first 12 hours and take it easy for the first week. However, you may resume your normal activities as tolerated. Minimal exercise (walking) appears to help the drainage finish more quickly. If swelling is more than mild and there is discomfort you may be too active. If your knees or arms have been done elevate them for the first 12-24 hours to decrease swelling in the ankles, feet, forearms and hands. There may be significant swelling in the pubic region after lower abdominal liposuction.
11. Therapeutic massage is very useful. It may be performed as often as every day. Whirlpools and hot tubs may be started one week after surgery.
12. Realize that healing is somewhat of a slow process and do not expect immediate results.
13. Avoid sun exposure until all the bruising has faded and the incisions are well healed.
14. For itching, take two Benadryl 25 mg. tablets every four hours.
15. It is important that you expect improvement and not perfection. Improvement can be anticipated up to six months.
16. Smoking post-operatively is strongly discouraged.