Liposuction

Introduction to Liposuction...

Liposuction slims and reshapes specific areas of the body by removing excess fat deposits and improving your body contours and proportion.
Liposuction, also known as lipoplasty ("fat modeling"), or simply lipo is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere.
Several factors limit the amount of fat that can be safely removed in one session. Ultimately, the operating physician and the patient make the decision. There are negative aspects to removing too much fat. Unusual "lumpiness" and/or "dents" in the skin can be seen in those patients "over-suctioned". The more fat removed, the higher the surgical risk.
Not everyone is a good candidate for liposuction. It is not a good alternative to dieting or exercising. To be a good candidate, one must usually be over 18 and in good general health, have an ongoing diet and exercise regimen, and have fatty pockets of tissue available in certain body areas. Significant disease limiting risk (e.g. Diabetes, any infection, heart or circulation problems) weigh against the eligibility of a person for the procedure. In older people, the skin is usually less elastic, limiting the ability of the skin to readily tighten around the new shape. Liposuction of the abdominal fat should not be combined with simultaneous tummy tuck procedures due to higher risk of complications and mortality.

LIPOSUCTION techniques:

In general, fat is removed via a cannula (a hollow tube) and aspirator (a suction device). Liposuction techniques can be categorized by the amount of fluid injection and by the mechanism in which the cannula works.
Suction-assisted liposuction (SAL): Suction-assisted liposuction is the standard method of liposuction. In this approach, a small cannula (like a straw) is inserted through a small incision. It is attached to a vacuum device. The surgeon pushes and pulls it in a forwards and backwards motion, carefully through the fat layer, breaking up the fat cells and drawing them out of the body by suction.
Ultrasound-assisted liposuction (UAL): In ultrasound-assisted or ultrasonic liposuction, a specialized cannula is used which transmits ultrasound vibrations within the body. This vibration bursts the walls of the fat cells, emulsifying the fat (i.e., liquefying it) and making it easier to suction out. UAL is a good choice for working on more fibrous areas, like the upper back or male breast area. It takes longer than traditional liposuction, but not longer than tumescent liposuction. There is slightly less blood loss. There appears to be slightly more risk of seromas forming (pockets of fluid) which may have to be drained with a needle. After ultrasonic liposuction, it is necessary to perform suction-assisted liposuction to remove the liquified fat. Ultrasound-assisted liposuction techniques used in the 1980s and 1990s were associated with cases of tissue damage, usually from excessive exposure to ultrasound energy. Third-generation UAL devices address this problem by using pulsed energy delivery and a specialized probe that allows physicians to safely remove excess fat.
Power-assisted liposuction (PAL): PAL uses a specialized cannula with mechanized movement, so that the surgeon does not need to make as many manual movements. Otherwise it is similar to traditional SAL.
Twin-cannula (assisted) liposuction (TCAL or TCL): Twin cannula (assisted) liposuction uses a tube-within-a-tube specialized cannula pair, so that the cannula which aspirates fat, the mechanically reciprocated inner cannula, does not impact the patient's tissue or the surgeon's joints with each and every forward stroke. The aspirating inner cannula reciprocates within the slotted outer cannula to simulate a surgeon's stroke of up to 5 cm (2 in) rather than merely vibrating 1–2 mm (1/4 in) as other power assisted devices, removing most of the labor from the procedure. Superficial or subdermal liposuction is facilitated by the spacing effect of the outer cannula and the fact that the cannulas do not get hot, eliminating the potential for friction burns.
External ultrasound-assisted liposuction (XUAL or EUAL): XUAL is a type of UAL where the ultrasonic energy is applied from outside the body, through the skin, making the specialized cannula of the UAL procedure unnecessary. It was developed because surgeons found that in some cases, the UAL method caused skin necrosis (death) and seromas, which are pockets of a pale yellowish fluid from the body, analogous to hematomas (pockets of red blood cells). XUAL is a possible way to avoid such complications by having the ultrasound applied externally. It can also potentially cause less discomfort for the patient, both during the procedure and afterwards; decrease blood loss; allow better access through scar tissue; and treat larger areas. At this time however, it is not widely used and studies are not conclusive as to its effectiveness.
Water-assisted liposuction (WAL): WAL uses a thin fan-shaped water beam, which loosens the structure of the fat tissue, so that it can be removed by a special cannula. During the liposuction the water is continually added and almost immediately aspirated via the same cannula. WAL requires less infiltration solution and produces less immediate edema from the tumescent fluid.
Laser Assisted: A laser is used to melt the fat in the target area, making it easier to remove. This laser is administered through a fibre threaded through a microcannula. The premise is similar to UAL. It is believed that this technique can also reduce bruising and bleeding, as it also cauterizes to a certain extent.
Sutures: Since the incisions are small, and the amount of fluid that must drain out is large, some surgeons opt to leave the incisions open, the better to clear the patient's body of excess fluid. They find that the unimpeded departure of that fluid allows the incisions to heal more quickly. Others suture them only partially, leaving space for the fluid to drain out. Others delay suturing until most of the fluid has drained out, about 1 or 2 days. In any case, while the fluid is draining, dressings need to be changed often. After one to three days, small self-adhesive bandages are sufficient. Doctors disagree on the issues of scarring with not suturing versus resolution of the swelling allowed by leaving the wounds open to drain fluid.
Depending on the extent of the liposuction, patients are generally able to return to work between two days and two weeks. A compression garment which can easily be removed by the patient is worn for two to four weeks, this garment must have elasticity and allow for use of bandages. If non-absorbable sutures are placed, they will be removed after five to ten days.

TREATMENT side effects:

A side effect, as opposed to a complication, is medically minor, although it can be uncomfortable, annoying, and even painful.
     
  •  - Bruising: can be painful in the short term, and should fade after a few weeks.
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  •  - Swelling: should subside gradually over a month or two.
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  •  - Scars: will vary in size depending on the particular procedure, and should fade over the weeks.
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  •  - Pain: should be temporary and controlled by either over-the-counter medication, or by a prescription.
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  •  - Numbness: sometimes persists for a few weeks.
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  •  - Post-operative weight gain
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  •  - Limited mobility: will depend on the exact procedure.

POSSIBLE complications:

The more serious possible complications include:

  • 1. Allergic reaction to medications or material used during surgery.

  • 2. Infection: any time the body is incised or punctured, bacteria can get in and cause an infection.

  • 3. Damage to the skin: most surgeons work on the deeper levels of fat, so as to avoid wounding the skin any more than they must for the insertion of the cannula.Sometimes the cannula can damage tissue beneath the skin, which may show up as a spotted appearance on the skin surface.

  • 4. Skin necrosis (dead skin) is a rare complication, in which the skin falls off in the necrotic area. The problem can vary in degree. The resulting wound then needs to heal typically requiring extended wound care.

  • 5. Puncture of an internal organ: since the surgeon cannot see the cannula, sometimes it damages an internal organ, such as the intestines during abdominal liposuction. Such damage can be corrected surgically, although in rare cases it can be fatal. An experienced cosmetic surgeon is unlikely to puncture any internal organ.

  • 6. Contour irregularities: sometimes the skin may look bumpy and/or withered, because of uneven fat removal, or poor skin elasticity. Not all patients heal in the same way, and with older patients the healing may be slower and a bit imperfect. Sometimes a small touch-up procedure can help.

  • 7. Thromboembolism and fat embolisation: although liposuction is a low-risk procedure for thromboembolism including pulmonary embolism, the risk cannot be ignored.

  • 8. Burns: sometimes the cannula movement can cause friction burns to skin or nerves. Also, in UAL, the heat from the ultrasound device can cause injury to the skin or deeper tissue.

  • 9. Lidocaine toxicity: when the super-wet or tumescent methods are used, too much saline fluid may be injected, or the fluid may contain too high a concentration of lidocaine. Then the lidocaine may become too much for that particular person’s system. Lidocaine poisoning at first causes tingling and numbness and eventually seizures, followed by unconsciousness and respiratory or cardiac arrest.

  • 10. Fluid imbalance: since fat contains a lot of fluid and is removed in liposuction, and since the surgeon injects fluid for the procedure, even a very large amount of it for tumescent liposuction, there is a danger of the body’s fluid balance being disturbed. This could happen afterwards, after the patient is at home. If too much fluid remains in the body, the heart, lungs and kidneys could be badly affected.

available Systems


LipoLifeTM

Alma Lasers

Laser assisted lipolysis remains a popular treatment with patients seeking a reduction of fat. Now, providers around the globe are expanding their practice with LipoLife, the solution for fast and safe suction with 1470nm diode laser patented* technology. LipoLife helps simplify your laser assisted lipolysis procedures with simultaneous laser and suction. Providers can reduce treatment times, minimize body traumas such as hemotomas and bruising, while enjoying enhanced control of fat removal and high accuracy.


Smartlipo TriplexTM

Cynosure

Smartlipo Triplex is the market standard in laser lipolysis, offering three unique wavelengths: 1064 nm, 1320 nm, and 1440 nm. These wavelengths can be used in single or blended mode using Smartlipo’s MultiPlex™ technology and unique SmartSense™-ThermaGuide™-ThermaView™ intelligent delivery systems, to deliver optimal patient outcomes.


QCW Nd:YAG laser

Fotona

Fotona's laser lipolysis procedure does not require the use of a general anesthetic. A very fine laser fiber is inserted into the treatment area, where the laser light causes swelling and rupture of adipocytes. When the fat is melted, it can either be absorbed by the body or removed by the physician.


QuadroStar PROTM

Asclepion Laser Technologies

The laser assisted lipolysis is used for treatment of cellulite and body shaping as well as reduction of localized fat and skin tightening. Furthermore cosmetic corrections of skin unevenness and laxity of skin after normal liposution. By generation of heat the tissue is homogenized and evened out, which can rarely or not been done with a normal liposuction. Laser assisted liposuction describes a ”melting” of fat with laser energy and – in some cases – suction of the developed “melted” fat.


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