If You’re Considering Liposuction

Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck.

During the past decade, liposuction, which is also known as “lipoplasty” or “suction lipectomy,” has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping Dr. Mabourakh to provide selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don’t respond to traditional weight-loss methods.

If you’re considering liposuction, this page will give you a basic understanding of the procedure – when it can help, how it is performed and how you might look and feel after surgery. It won’t answer all of your questions, since much depends on your individual circumstances. Please ask Dr. Mabourakh if there is anything about the procedure you don’t understand.

The Best Candidates For Liposuction

To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. It’s important to understand that liposuction can enhance your appearance and self confidence, but it won’t necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Mabourakh.

The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.

Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.

Planning Your Surgery

In your initial consultation, Dr. Mabourakh will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. He will explain the body-contouring methods that may be most appropriate for you. For example, if you believe you want liposuction in the abdominal area, you may learn that an abdominoplasty or “tummy tuck” may more effectively meet your goals; or that a combination of traditional liposuction and UAL would be the best choice for you.

Be frank in discussing your expectations with Dr. Mabourakh. He will be equally frank with you, describing the procedure in detail and explaining its risks and limitations.

Getting The Answers You Need

Individuals considering liposuction often feel a bit overwhelmed by the number of options and techniques being promoted today. However, Dr. Mabourakh will help. In deciding which the right treatment approach is for you, Dr. Mabourakh will consider effectiveness, safety, cost and appropriateness for your needs. This is called surgical judgment, a skill that is developed through surgical training and experience. He also uses this judgment to prevent complications; to handle unexpected occurrences during surgery; and to treat complications when they occur.

Dr. Mabourakh’s education and training have helped to form his surgical judgment, so take the time to do some background checking. Patients are encouraged to consider a doctor certified by the American Board of Plastic Surgery (“ABPS”). By choosing a plastic surgeon who is certified by the ABPS, a patient can be assured that the doctor has graduated from an accredited medical school and completed at least five years of additional residency – usually three years of general surgery (or its equivalent) and two years of plastic surgery. To be certified by the ABPS, a doctor must also practice surgery for two years and pass comprehensive written and oral exams.

Preparing For Your Surgery

Dr. Mabourakh will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed.

Though it is rarely necessary, Dr. Mabourakh may recommend that you have blood drawn ahead of time in case it is needed during surgery.
Also, while you are making preparations, be sure to arrange for someone to drive you home after the procedure and, if needed, to help you at home for a day or two.

Where Your Surgery Will Be Performed

Liposuction may be performed in Dr. Mabourakh’s office-based facility, in an outpatient surgery center, or in a hospital. Smaller-volume liposuction is usually done on an outpatient basis for reasons of cost and convenience. However, if a large volume of fat will be removed, or if the liposuction is being performed in conjunction with other procedures, a stay in a hospital or overnight nursing facility may be required.

Anesthesia For Liposuction

Various types of anesthesia can be used for liposuction procedures. Together, you and Dr. Mabourakh will select the type of anesthesia that provides the most safe and effective level of comfort for your surgery.

If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under local anesthesia, which numbs only the affected areas. However, if you prefer, the local is usually used along with intravenous sedation to keep you more relaxed during the procedure. Regional anesthesia can be a good choice for more extensive procedures. One type of regional anesthesia is the epidural block, the same type of anesthesia commonly used in childbirth.

However, some patients prefer general anesthesia, particularly if a large volume of fat is being removed. If this is the case, a board certified anesthesiologist will administer your anesthesia.

The Surgery

The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used.

There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance outcome.

Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on Dr. Mabourakh’s preference and your needs. If many sites are being treated, he will then move on to the next area, working to keep the incisions as inconspicuous as possible.

Fluid is lost along with the fat, and it’s crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery.

Technique Variations

The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.

Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by Dr. Mabourakh. The fluid — a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) — helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.

The amount of fluid that is injected varies depending on the preference of Dr. Mabourakh and your needs.

Large volumes of fluid – sometimes as much as three times the amount of fat to be removed — are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as 3 to 4 hours). However, because the injected fluid contains an adequate amount of anesthetic, additional anesthesia may not be necessary. The name of this technique refers to the swollen and firm or “tumesced” state of the fatty tissues when they are filled with solution.

The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.

Ultrasound-Assisted Lipoplasty (UAL). This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique.

UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.

After Your Surgery

After surgery, you will likely experience some fluid drainage from the incisions. Occasionally, a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. To control swelling and to help your skin better fit its new contours, you will be fitted with a snug elastic garment to wear over the treated area for up to six weeks. Dr. Mabourakh may also prescribe antibiotics to prevent infection.

Don’t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by Dr. Mabourakh, though you may still feel stiff and sore for a few days.

It is normal to feel a bit anxious or depressed in the days or weeks following surgery. However, this feeling will subside as you begin to look and feel better.

Getting Back To Normal

Healing is a gradual process. Dr. Mabourakh will probably tell you to start walking around as soon as possible to reduce swelling and to help prevent blood clots from forming in your legs. You will begin to feel better after about a week or two and you should be back at work within a few days following your surgery. The stitches are removed or dissolve on their own within the first week to 10 days.

Activity that is more strenuous should be avoided for about a month as your body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more.

Dr. Mabourakh will schedule follow-up visits to monitor your progress and to see if any additional procedures are needed.

If you have any unusual symptoms between visits — for example, heavy bleeding or a sudden increase in pain — or any questions about what you can and can’t do, call Dr. Mabourakh.

Your New Look

You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.

If your expectations are realistic, you will probably be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.

Tumescent Technique

The tumescent technique is a relatively new liposuction method that can reduce post operative bruising, swelling and pain. Because blood loss is minimized during tumescent liposuction, use of the technique reduces the chance that a blood transfusion will be needed.

In the tumescent technique, areas of excess fat are injected with a large amount of anesthetic liquid before liposuction is per-formed. The liquid causes the compartments of fat to become swollen and firm or “tumesced.” The expanded fat compartments allow the liposuction cannula to travel smoothly beneath the skin as the fat is removed.

Any person who is a candidate for traditional liposuction is also a good candidate for the tumescent technique. Although the technique can be used on any area of the body, it is commonly used on areas that require enhanced precision, such as the face, neck, arms, calves and ankles.

Individuals who have large areas of excess fat may also be good candidates for tumescent liposuction.

Although the anesthesia requirements are lessened and blood loss is minimized with tumescent liposuction, patients undergoing the procedure still face the same risks and cosmetic complications associated with traditional liposuction surgery.

There are also risks specifically associated with the tumescent technique. These rare complications include pulmonary edema (the collection of fluid in the lungs), which may occur if too much fluid is administered; and lidocaine toxicity, which occurs if the solution’s lidocaine content is too high.

For many patients, general anesthesia is the best option. For others, the anesthetic contained in the solution combined with sedation may provide sufficient comfort during the procedure. Or, if Dr. Mabourakh feels it’s appropriate, the tumescent solution itself may serve as the sole means of anesthesia.

In tumescent liposuction, the warmed tumescent liquid — a dilute solution containing lidocaine, epinephrine and intravenous fluid — is injected into the area to be treated. As the liquid enters the fat, it becomes swollen, firm and blanched. Liposuction is then performed on the tumesced areas.

The long-acting effects of the anesthetic solution help to provide pain relief after the procedure and decrease the need for additional pain medication. For the first day or two after surgery, most patients experience swelling in the treated areas, as well as some fluid drainage from the incision sites. Light activity is usually resumed within the first few days after tumescent liposuction; normal activity can be resumed within a few weeks.

Patients are usually able to see a noticeable difference almost immediately after surgery. However, more improvement can be seen after three weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling will disappear and the final contour will be visible.

Patients are usually very pleased with the results of the procedure. By eating a healthy diet and getting regular exercise, you can help to maintain your slimmer figure or leaner physique.