Although we all try to create the body we desire through diet and exercise, because of genetic factors and age, we are sometimes unable to achieve our goals. The many techniques available for body contouring can now make positive changes possible.
Liposuction is a very common procedure for fat removal. Modern liposuction involves instillation of fluid into the fatty tissues to be removed, the tumescent technique. This allows more fat to be removed safely with little bruising. Through a few tiny incisions, fat is suctioned away. Standard liposuction uses a vacuum device, whereas, ultrasonic liposuction generates ultrasonic energy which liquefies the fat prior to removal. Some devices use laser energy to liquefy the fat. The important part of the process is the removal of fat and the technique utilized is dependent on the surgeon’s preference; the ultimate outcome is the same.
Liposuction is very useful when the elasticity and quality of the skin is good. Patients with a significant amount of excess skin may require other procedures such as abdominoplasty, thigh lift or brachioplasty to remove skin (see below). Liposuction is commonly performed on the abdomen, hips, thighs, ankles and neck. Liposuction is also used as a contouring technique during other procedures such as facelift, abdominoplasty and thigh lift.
COMMENTARY ON LIPOSUCTION (Dr. Higgins)
While liposuction may be the most common procedure performed annually, it is more often than not performed poorly. At first glance, liposuction may seem simple– just suck out some fat and its all good– not exactly. Liposuction should be left in the hands of a board certified plastic surgeon.
Lipo should be thought of as body contouring, not weight loss. Liposuction works best on areas that are resistant to diet and exercise– like those saddle bags that are there en when you are at you personal thinnest or those love handles that you cant exercise away.
Successful liposuction requires good skin tone or elasticity. Once fat is removed from an area, the skin in that area has to contract and redrape over that site. The better the elasticity of the skin, the better the post operative result.
Think of a balloon tight and full of air– if you remove some air, the balloon skin is still smooth. Now think of a balloon already loose and half way deflated. Now consider removing more air from that balloon. The skin on the balloon becomes loose and flaccid and irregular.
Thats how to think of liposuction.
There are multiple modalities used in lipo– Tumescent, Smart Lipo (laser), Vaser or Ultrasonic, and Wet Jet Lipo.
Smart lipo is designed to help tighten overlying skin. It does NOT replace standard liposuction. Results are limited to small areas.
Vaser or Ultrasonic lip is used for more fibrous fat deposits that are difficult to extract. It is usually used in conduction with standard tumescent liposuction.
Wet Jet liposuction is a newer technology that uses water jet stream to help separate the fat cells to make them theoretically easier to extract. It is used in conjunction with standard tumescent liposuction.
Abdominoplasty or Tummy Tuck
Abdominoplasty removes excess skin from the upper and lower abdomen and tightens the underlying muscles. This technique is often used to correct problems after pregnancy. For those patients with excess skin and muscle weakness below the belly button, a mini-abdominoplasty may be adequate.
COMMENTARY ON ABDOMINOPLASTY (Dr. Higgins)
I consider most abdominoplasties reconstructive/repairative procedures from the damage done from pregnancy. Typically there are 3 things occur as a result of childbearing;
- Excess Skin
- Stretch Marks or damaged skin
- Rectus Abdominis muscle separation or diastasis
In my practice, many women blame themselves for not being able to get back their pre-pregnancy tummies despite diet and exercise. The truth is that without surgical intervention, this goal is nearly impossible for many women.
Many patients have previous c-section scars and are living with scars in same position as an abdominoplasty. With the addition of a few more inches of scar my patients can achieve a tight, taut tummy. Also, many of my patients have extensive stretch marks over the abdomen. At present, there is no effective treatment for stretch marks. Stretch marks are a break in the deeper layer of the skin resulting in damaged or scarred skin. The only way to effectively remedy this damaged skin is to excise it with a tummy tuck.
Medial Thigh Lift
The inner thighs often become loose with age or weight loss. The medial (inner) thigh lift is performed when there is a large amount of excess skin in the inner thighs. The incision is placed in the natural inner thigh crease.
Brachioplasty or Upper Arm Lift
This procedure removes skin from the upper arms when there is a large amount of excess. It results in a vertical scar from the armpit to elbow. Sometimes smaller incisions can be employed in the armpit if the skin excess is less severe.
Lower Body Lift
The lower body lift removes excess skin from the lower body circumferentially and is reserved for patients with large amounts of excess skin.
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