LIPOSUCTION & ABDOMINOPLASTY

LIPOSUCTION

Liposuction is the most commonly performed procedure by plastic surgeons in the United States today. It can be performed as an isolated procedure or often is an adjunct to another surgical procedure such as a rhytidectomy (face lift) or abdominoplasty (tummy tuck). Liposuction is a technique used for "body sculpting." Liposuction is not an alternative to weight loss. The classic "ideal" candidate for liposuction is a patient at or near his/her ideal weight who has isolated areas of fat that cannot be reduced by diet and exercise alone. Currently there are three different liposuction techniques:

Conventional liposuction
Ultrasonic liposuction
Power-Assisted liposuction.

The traditional or conventional liposuction is the "gold standard" against which the other two techniques must be measured and is the technique, which is most commonly used.

Liposuction is used to improve the contour of such areas of the body as the hips, buttock, abdomen, thighs, knees, ankles, face, neck, arms, back and "love-handles." The surgeon will make one or two small incisions, which are approximately ¼ inch or 5 mm in length. The surgeon's instrument used for liposuction is called a cannula. The cannula is a long, thin round metallic instrument with a handle at one end. The cannula is connected to the liposuction machine through a sterile, disposable tubing. The surgeon will pass the cannula through the small incisions to the site to be sculpted. Negative pressure or suction in the liposuction machine causes the fat to pass through the cannula and the tubing. The fat is collected in a bottle or canister on top of the liposuction machine.

At the end of the procedure, the small incisions are closed with either a single stitch or a small "butterfly" bandage. The patients are then given a special compression garment to wear for the next several weeks. Ultrasonic liposuction is often used in those areas in which the fat is more difficult to remove. These areas include the male breast (gynecomastia) and the love handle region. Ultrasonic liposuction requires special, more costly machines and instruments, special training in their use, and has been associated with a higher complication rate than conventional liposuction. Power assisted liposuction is the newest of the liposuction techniques. Its indications are similar to that of ultrasonic liposuction. It requires a second machine and a special cannula with a tip that will move back and forth and help the surgeon by breaking up the fibrous tissue "protecting" the fat. The fat is then removed by a conventional liposuction machine. Power assisted liposuction appears to achieve the same stated advantages of ultrasonic liposuction at a lower cost and without the same increase in risk.

After all three types of procedures, patients are placed in a gentle, compression garment which is worn for three weeks. Patients can shower daily after the procedure. Patients can often return to work and resume light activities after several days. Full aerobic exercise is restricted for 3 weeks.The specific risks and the suitability of these procedures for a given individual can be determined only after a personal consultation.

ABDOMINOPLASTY (TUMMY TUCK)

The abdominoplasty or tummy tuck procedure is used to flatten and reshape the abdomen, tighten the abdominal musculature and remove excess deposits of fat. There are three types of abdominoplasty: the standard or full abdominoplasty, the mini-abdominoplasty, and the endoscopic abdominoplasty. In the mini-abdominoplasty an incision is made over the pubic area which extends approximately for one-half the width of the abdomen. Excess deposits of fat may be removed before the incision is made using conventional, power assisted or ultrasonic liposuction. After the incision is made the skin and fat are elevated off the underlying muscle fascia up to the level of the umbilicus or belly button. Any ventral hernia of the abdomen or separation of the muscles (diastasis recti) is repaired. The excess skin is removed and the incision is sutured close. The patient is placed in an abdominal binder, which is worn for 3 weeks.

The endoscopic abdominoplasty tightens the muscles of the abdomen through one or two small incisions. Although liposuction is often performed at the same time there is no tightening of the skin performed.

The full abdominoplasty requires an incision that extends along the lower abdomen from "hip-to-hip." In addition, as incision is made around the umbilicus or belly button because the separation of the skin and fat off the muscle of the abdomen extends up to the rib cage. Although the mini-abdominoplasty and the endoscopic abdominoplasty can be performed under an intravenous sedation with local anesthesia, the full abdominoplasty generally requires general, epidural or spinal anesthesia. Recovery from the full abdominoplasty is slightly longer than from the other two procedures. It is usually performed in the hospital, and patients often require drains, which are left in place for several days.

The treatments listed are not intended to be complete or comprehensive. The specific risks and the suitability of these procedures for a given individual can be determined only after a personal consultation. Please email us at info@rothausmd.com or call us at 212.737.0770 to schedule a consultation.

For additional information on Laser Aesthetic Procedures, go to www.lasersandplasticsurgery.com.