Abdominal Liposuction

Abdominal liposuction is the most common of the liposuction procedures, since there are so many women and men who have fatty deposits there and want a flatter stomach. Fat deposits in the abdominal region tend to be the ones that resist the effects of exercise and diet.

Most patients who opt for abdominal liposuction have exhausted their attempts to lose that fat with dieting, training and exercise. Abdominal fat, or visceral fat, does not respond the way other fat does, when you diet and work out. But it does respond well to abdominal liposuction, so patients are usually very pleased at the results of this procedure. To add to this, the effects achieved with this liposuction are permanent, barring unusual circumstances.

You need only be subjected to a local anesthetic for the tumescent technique, so this eliminates the worries and risks and cost associated with general anesthesia. The trauma brought to the fatty tissue, and the bleeding caused are reduced dramatically with the tumescent liposuction technique. And most patients who have abdominal liposuction with the newer technique can be back to work in a few days.

Fat tends to localize itself in the abdominal area, and it is resistant to a lot of the exercise and diet that you may subject your body to, in trying to lose it. But this area responds well to liposuction. This is the reason that many men and women opt for abdominal liposuction to gain a flatter stomach.

The fat in your abdominal area can be intra-abdominal (internal) or subcutaneous (right under the skin). If you suffer from the internal fat, it can’t be removed by liposuction, because it’s too far inside the abdomen. Subcutaneous fat responds readily to liposuction, since it’s above the abdominal muscles. If your fatty look comes from bulging abdominal muscles, liposuction won’t help you, because that isn’t tissue that can be suctioned out.

You can test yourself to determine if you have the type of fat that will respond to abdominal liposuction. If you are able to grab a fold of your skin between your fingers and thumb, and it feels soft and is easily moved up and down, this is likely a fat deposit that will be amenable to liposuction.

Traditionally, the tummy tuck was the procedure of choice, but this is being overshadowed now by the acceptance of abdominal liposuction. The tumescent procedure uses small cannulas, and can give you the look of a tummy tuck without the invasiveness. If it’s determined that you still need a tummy tuck, you need only wait a time after the liposuction, and then it can still be done. But the success rate of abdominal liposuction is such that subsequent tummy tucks are not often needed anymore.

Tumescent liposuction is performed while the patient is only under a local anesthetic, so the risks and side effects are greatly decreased. Your abdominal area will be anesthetized and the incisions made are very small. Fatty deposits are removed from all different directions, to insure that the results will be even.

After your abdominal liposuction, you are usually able to get right up and walk. The surgeon will apply a mild compression garment and dressings after the procedure is finished. You will be given detailed written and verbal instructions to follow. You will be told what to expect up-front, and this will ensure that you won’t have much difficulty or worry after the procedure is finished. Find all the details about Cosmetic surgery.

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Liposuction Surgery Techniques in Body Contouring

Tumescent Liposuction

Developed about 15 years ago, this is the most common, and safest, method. The term “tumescence” refers to the swelling and firming of fatty tissues by the means of infusing fluid into the tissue. After tiny incisions are made where the patient’s skin covers fatty tissue, the area is soaked with a saline solution that contains an anesthetic (Lidocaine) and adrenaline to reduce blood loss and bruising. This reduction of blood loss through the shrinking of capillaries has been a great advance, enabling plastic surgeons to remove much fat with little blood loss.Tumescent liposuction involves swelling the areas to be suctioned with a solution that equals two to three times the amount of the fat and fluid that will be suctioned out. In the Super-Wet technique however, the tissues are infused with an amount of fluid that equals the fat and fluids that will be suctioned. Super-wet involves the use smaller amounts of, or no, Lidocaine, thereby reducing the risk of Lidocaine toxicity.

Once the area has been sufficiently plumped up, the surgeon removes these fat cells through the insertion of a cannula, a tiny wand like instrument that suctions and removes the loosened fat cells via a high-power suction machine. The fat then glides through transparent vacuum-like tubes as fat and fluid are suctioned from your body. Because of the fluid loss, you need to be monitored carefully by an experienced anesthesiologist who can balance your fluid intake and output throughout the procedure.

There is nothing arbitrary about this process. A skilled surgeon, like a sculptor, has to use his sense of sight and touch to assess the areas of fat buildup and to contour and sculpt these areas into an ideal form. It also requires a great deal of arm movement and exertion by the surgeon, as he or she both suctions and sculpts. The tumescent technique has a low complication rate in and of itself, yet is also used as preparation for other kinds of liposuction techniques.

Power Assisted Liposuction

In essence, this is liposuction hastened by a vibrating suction cannula. Developed by a German surgeon, this technique employs an electric-powered cannula, which like a jackhammer sucks out the fat faster. In my opinion, while it might help the surgeon to do his or her job faster, it takes away from the surgeon’s ability to feel the contour and the topography of tissue as this machine vibrates. Also, this machine might not be safe to be used in delicate or potentially dangerous areas such as the neck and face.

Ultrasonic Assisted Liposuction (UAL)

This method was first used in the 1990’s, and was considered an advance in treating especially fibrous areas, such as the male chests, back, and flanks. It uses cannulas that bombard subcutaneous fatty tissues with waves of ultrasound, thereby liquefying them through ultrasound energy and heat. An external method also delivers this energy by applying a paddle-shaped instrument to the skin. The higher general complication rate of this technique as compared to other conventional techniques has recently drawn surgeons away from this fad. Specifically, ultrasonic assisted lipoplasty (UAL) carries an increased risk of skin and tissue burns, permanent tissue damage and scarring, nerve damage causing lasting skin irritation or pain, and fluid buildup or formation of seroma – cavities of fluid beneath the skin. Because there is insufficient proof of the safety of UAL devices, the Food & Drug Administration (FDA) has never approved the marketing and advertising of UAL devices.

What is Large Volume Liposuction?

What person today has not heard of gastric bypass surgery, more commonly known as “stomach stapling?” The news stories about musicians, new anchors and other celebrities who have undergone this procedure are frequent. Yet, only twenty years ago, the mere mention of gastric bypass would have elicited a declaration of “that would be malpractice!” In much the same way, our assessments about the safety of Large Volume Liposuction are progressing.

Notions of what is attractive are constantly evolving. The voluptuous actresses of the 1950’s would today be considered overweight. However, while we can’t really define what an “ideal” weight is, it is widely accepted that a significant portion of Americans today are overweight. This is both a health issue, and a self-esteem issue. More than half of American women wear a size 10 or more, and are unhappy with their size.

Just as the safety of gastric bypass surgery was once questioned, so is the acceptability of Large Volume Liposuction. However, in the hands of a skilled and experienced plastic surgeon who takes all of the usual precautions that are observed during any major surgery, a patient can successfully and safely have large amounts of fat removed.

When approximately two liters of fat (about the size of a Coca-Cola bottle) are removed, this is considered Small Volume Liposuction. This is successful when smaller localized “problem” areas of the body are being contoured. However, the removal of this quantity of fat will not make a difference in a large person whose goal is significant size reduction. In the latter case, large volumes of fat, five or more liters are removed, with the dramatic outcomes- 2 to 5 size reduction in cloth size. The surgeon removes the fat with an eye towards contouring the area as well. In this procedure, it is a good practice to combine the Tumescent with the Super-Wet Technique, as the latter does not use Lidocaine (or uses less), thereby avoiding the risk of Lidocaine toxicity.

If you are considering liposuction you should seek a plastic surgeon who has very extensive experience in performing this procedure in an optimal surgical facility. A minority of qualified plastic surgeons specializes in this.

Male flanks liposuction using the KleinLipo technique performed by Dr. Jeffrey A. Klein. The KleinLipo technique is the safest type of liposuction surgery with superior cosmetic results.

The Science of Liposuction

Liposuction, after 25 years, is still one of the most popular plastic surgeries. How it works, however, is not generally well understood. It is more than ‘sticking a tube in and sucking it out’. The basics principles of flow mechanics apply

At its simplist, liposuction is a two-steo process for removing fat. A hollow tube (cannula) is put under the skin, the tube is moved back and forth until the fat is dislodged, and the attached vacuum source draws the fat back through the cannula into the tubing and finally into the plastic bottle.

Despite this apparent simplicity, there is more science to it than that. There are three interesting components about liposuction, all of which contribute to its safety and effectiveness. These include the concept of tumescence, water vaporization and suction, and tubing size and design.

An integral part of the oepration is the placing of fluid into the areas where the fat will be suctioned. I frequently get asked by patients if I do tumescent liposuction. Most patients think that tumescence is a special liposuction technique when, in fact, it is part of every liposuction procedure. Putting large amounts of fluid into the fat areas to be suctioned beforehand is known as tumescent infiltration. This achieves two fundamental things, substantially reduces bleeding (from the fat being broken up by the liposuction tube and it distends the fat compartments which make the tube easier to pass through the fat being suctioned. Without tumescent infiltration, liposuction would quite bloody, give patients more pain, and have them bruised for a month, if not longer.

The amount of suction generated by the liposuction machine, in short, makes liposuction possible. At the accepted amount of suction needed for liposuction (-20 cms of water or -1 atmosphere of pressure), the pulling of fat through the tubing certainly occurs. But it also causes the vaporization of water. If you have ever witnessed an actual liposuction procedure, you may have seen bubbles in the fat or bubbling in the plastic cannister. To some degree, this is actually water boiling….or the vacuum pressure exceeding the vapor pressure of the water in the fat being removed. It is this vaporization that makes the viscosity (how thick it is) of fat, which is actually a combination of fat, blood, and infiltration fluid, less to improve its ease of flow through the tubing. From a flow standpoint, water that is vaporized ( a gas) flows 100 times faster than liquid water. This is also why liposuction done at higher altitudes, where the water vapor of pressure is less, is somewhat easier to do. (takes less suction from the machine)

The tube (cannula) that is actually used under the skin differs in diameter and the holes at the tip. In days gone by, the cannulas were quite large but left a lot of depressions in the overlying skin after due to removing too much fat too fast and in large pieces. Today, small cannulas are used which removes fat more carefully and in smaller pieces, decreasing the problem of skin irregularities after surgery. The tip of the cannula is rounded so that it travels through the fat easier with less chance of penetrating something you shouldn’t. The holes at the tip are where fat sticks to and then gets sucked into the cannula. The more holes there are at the tip achieves two effects; increases the shearing effect (like a blade) on fat and makes more cross-sectional area through which fat can be suctioned.

Currently, there are newer methods of liposuction or to be accurate, methods of loosening up the fat. These include ultrasonic and laser-assisted. While they sound quite advanced (and they are), there is no convincing evidence at this time that they are actually better than traditional liposuction. Better meaning….you get more fat oout, smoother skin, and heal faster. Manufacturers market them as such but no study has yet proven it. And suction is still required to pull out loosened fat.

Watch A Live Tumescent Liposuction procedure By Dr. William Hall. Tumescent Lipo Is Fast, Easy And Affordable. For more videos about liposuction and lipo FAQ visit www.ArizonaLipo.com

Liposuction Technology

The improved safety and effectiveness of liposuction are largely due to newer and better equipment and procedures. It is true of any medical procedure that the better the technology is, the safer and more efficient that procedure becomes for the patient and doctor. Of course the cosmetic surgeon’s skill is another factor in safety and effectiveness, and you would always want to choose a fully qualified and experienced plastic surgeon who is certified by the American Board of Plastic Surgery.

The types of liposuction currently being performed are:

• Ultrasonic-assisted

• Power-assisted

• Tumescent

• Super-wet

• SmartLipo

• Microcannula liposuction

• External ultrasound-assisted liposuction (XUAL)

Originally, liposuction was done without any fluid injected. This was traumatic for the patient, difficult for the doctor, and required substantial recovery time. As the years have gone by, fluid injection has gained more importance, with the amounts of fluid increasing in Wet Liposuction, then Super-Wet Liposuction, and then Tumescent Liposuction.

The fluid used is a saline solution (to match the salt content of natural body fluids), with two things added:

• Lidocaine – as a local anesthetic

• Epinephrine – to close off any blood vessels that might be damaged by the cannula

Why is fluid injected?

Mixed with fluid, the fat suctions out more quickly and smoothly. There has always been the question of: How much fluid? In tumescent liposuction, a larger amount is injected, as much as three or four times the amount of fat to be removed. All this fluid expands the area, creating more space for the cannula movements.

Cannula movement

The cannula is used to break up the fat cells. Breaking their surfaces emulsifies (liquefies) the fat, again making it easier to remove. In the early days, the cosmetic surgeon broke up fat cells by vigorously moving the cannula back and forth by hand. To reduce the risk of broken blood vessels or perforated body organs, methods were sought to make cannula movement more subtle and controlled.

Power-assisted liposuction (PAL)

An electrical-powered cannula was developed to refine cannula movement. A PAL procedure does not inject much fluid, so this was a limited improvement.

Ultrasound-assisted liposuction

A specialized cannula was developed which transmits ultrasound vibrations. This makes any manual movement unnecessary and reduces blood loss somewhat. It works well on fibrous areas like the male breast or the upper back. This cannula can be used in tumescent liposuction.

External ultrasound-assisted liposuction (XUAL)

In this method, the ultrasound is applied not through the cannula, but from a handpiece held against a special gel on the patient’s skin. It can help with one risk of UAL, namely the formation of seromas (pockets of fluid build-up which show as bumps on the patient’s skin). It’s the cosmetic surgeon’s judgment as to how much vibration to apply so its effectiveness is to some extent operator-dependent.

Microcannula liposuction

By using a more narrow cannula, incisions are smaller and fat can be removed from smaller areas than were first treated, such as the jawline.

Using a laser

SmartLipo™ is the name of a procedure which uses a laser to liquefy the fat. Lasers have been introduced to more and more medical and dental procedures because they are fast, precise, and safe. In SmartLipo, the laser directly dissolves the fat and can seal off any leaking blood vessels as it works, which reduces risk of infection. It is used with tumescent liposuction. Other lasers such as the CoolLipo and ProLipo lasers use different wave lengths to work on fat emulsification by heating the water inside the fat cells, which breaks the cell membrane.

The best cosmetic surgeons keep up with new technology through their professional memberships and various advanced-level seminars. But newest doesn’t always mean best, so if you’re considering liposuction for yourself, ask your potential cosmetic surgeon what he thinks of each liposuction variation, and choose one who has tested them and come to his own experience-based conclusions.

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Compression Garments After Liposuction

Type of Garment

For a certain period of time, most surgeons recommended that patients should wear an elastic compression garments after liposuction.  Such garments are deliberately to give constant postoperative compression to areas treated by liposuction.  A number of garments are created from Lycra kind of cloth.  Other garments are through elastic cloth usually to those that are used for girdles.  The garments are commonly crotch less so that the patient can urinate and defecate without taking it off.

An Elastic Compression Garments

Prior to the invention of the tumescent technique, to reduce the bleeding immediately after surgery and to reduce the swelling at the time that the body is healing, the use of elastic compression garments after liposuction or specially designed girdles are recommended in the early days of liposuction.  By way of the tumescent technique, there is constantly a certain amount of blood-tinged anesthetic solution which was left under the skin where the fat has been taken away.

This blood-tinged fluid will be the source of bruising and the post-operative swelling known as “osmotic-edema”.  The purpose of the compression garments relies on whether or not the surgeon seals cuts with stitches.  By way of the modern “open-drainage” technique for post-liposuction concern, the small cuts/slits are permitted to remain open, and the motive for using compression garments are worn for a few days is to encourage the fast flow of the remaining blood-tinged tumescent anesthetic solution from underneath the skin.  By way of “closed-drainage”, the motive for using compression garments are worn for several weeks is to oblige the assimilation of the blood-tinged anesthetic solution into the body’s blood vessels. 

The Period of Wearing Compression Garments

The length of time that a patient must be dressed in an elastic compression garment relies on the sort of post operation care technique recommended by the surgeon.  If the surgeon shuts the cuts with stitches then patients are commonly directed to wear a garment for two to six weeks.

If the surgeon sets stitches in the skin openings, then the blood-tinged tumescent solution is left confined underneath the skin that is the sources of lingering bruising, swelling, and tenderness, which consecutively entails the patient to wear an elastic compression garment for an extended duration of time.

An elastic compression garment is normally worn for an average of only three to six days by way of the open drainage technique, skin cuts are not closed with stitches, for after operation care.  In contrast, patients must be dressed in compression garments for 24 hours beyond the time when all flows stopped.  For example, if all the flow stops after three days after the tumescent liposuction of the outer thighs, the garments must be worn for four days.

Here are the risks of using Elastic Compression Garments after Liposuction.   Too much firmness can extend swelling and edema. Excessive compression after all the remaining blood-tinged anesthetic solution has stopped flowing.  It can mess up the normal function of lymphatic capillaries which is to suck up residual tumescent fluid and inflammatory exudates from the tissues of the liposuction site.

Too little firmness will let the buildup of fluid surrounded by the tunnels produced by the liposuction cannula within targeted fat.

Atlanta Plastic Surgery Doctor Advances Breast Reconstruction with New Liposuction and Mastectomy Technique Revealed …
Atlanta Board Certified Plastic and Reconstructive Surgeon Dr. James Namnoum Explains Water-Assisted (Body Jet) Liposuction Technique and Nipple-Sparing Mastectomy. (PRWeb February 23, 2011) Read the full story at http://www.prweb.com/releases/2011/02/prweb5092454.htm
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