By Dr. Jere Mammino and Dr. Robert Rosen
American Osteopathic College of Dermatology
Jun 2, 2004, 15:16
Keywords: liposuction, fat reduction, body sculture, weight reduction procedure
Tumescent liposuction is the technique permitting the greatest safety, the most rapid recovery, the least pain, and the best aesthetic results for liposuction. It is also the only technique that, in the hands of an expert surgeon, permits liposuction totally by local anesthesia, avoiding the dangers of general anesthesia, IV sedation and narcotic analgesics.
Body sculpture by liposuction removed localized accumulations of fat, which are often inherited and frequently prove impossible to eliminate by exercise or dieting.
Body fat of an adult tends to increase gradually over the years. After the age of 30, an individual tends to add fat according to a genetically predetermined pattern. This fat distribution is often resistant to exercising and dieting. An example of a genetically predetermined fat distribution that is resistant to dieting and exercise is the fat that appears on the abdomen and hips of a woman after pregnancy.
Liposuction involves the use of a small stainless steel tube, called a cannula. The cannula is connected to a very powerful suction pump and is inserted through small skin incisions. The removal of fat is accomplished as the suction cannula creates tiny tunnels through the fatty layers. After surgery, these tiny tunnels collapse resulting in an improved body contour.
Fat cells that are removed by liposuction do not grow back. The best candidates for liposuction are in good health and have realistic expectations of liposuction. There is neither definite age limit, nor weight limit for patients who are "good candidates" for liposuction. It is important to emphasize that liposuction is not a treatment for general obesity. Liposuction surgery is not effective as a last resort for people who are unable to maintain a reasonable weight by dieting. However, an overweight person whose weight has been stable for many years and has certain problem areas of fat may be an excellent candidate for liposuction.
The word tumescent means swollen and firm. The Tumescent Technique uses large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the drug epinephrine, which temporarily shrinks capillaries. Therefore there is minimal bleeding during and after surgery.
As with any surgical procedure, liposuction is associated with certain common side effects such as bruising, swelling and temporary numbness. Although irregularities of the skin are possible following liposuction, this side effect is minimized by the tumescent technique. Because of the slow resolution of post surgical swelling, the ultimate results following liposuction usually require 12 to 16 weeks to become fully apparent. Nevertheless, patients can usually see dramatic improvements within two to four weeks after surgery. Rare problems that can potentially occur with any surgical procedure include infections, bleeding and nerve injury.
To place the cannulas, tiny incisions are required. The incisions are so small that commonly no stitches are used. The wounds heal by themselves and all most disappear with time. Some patients do find the soreness after surgery more troubling than others, but on the average, most patients are quite surprised at how quickly they are able to return to normal activity.
Liposuction is a type of surgery that is appropriately performed by surgeons from several different specialties. The specialists who most commonly perform liposuction are dermatologic surgeons (dermatologists), cosmetic surgeons, gynecologist, and plastic surgeons.
Almost all dermatological surgeons who perform liposuction use local anesthesia by the tumescent technique. Dermatologists experienced in doing liposuction have the lowest rate of serious complications. Plastic surgeons are much more likely to commit medical malpractice during liposuction, at least on a statistical basis. Unfortunately plastic surgeons are also trying to prevent dermatologists from doing liposuction, perhaps for their own financial gain.
This article is taken from American Osteopathic College of Dermatology, used with permission.
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