Liposuction
Liposuction by the Tumescent technique gives the safety
and comfort of local anesthesia while microcannulas provide
smooth precise results.
Facial
and body sculpting by small volume tumescent liposuction
is a dream come true for many of our patients at Aesthetics
MD. Localized accumulations of fat, which are often genetically
determined, are usually resistant to exercise and dieting.
These can be removed permanently by liposuction surgery never
to return. Dr. Van Camp and Dr. Teng use the tumescent technique
and micro-cannulas pioneered by Dr. Jeffrey Alan Klein beginning
in 1985. Dr. Van Camp was personally trained in these methods
by Dr. Klein. The following will provide you with basic information
about these methods. We believe that the tumescent technique
provides an unparalleled level of safety and precision for
liposuction.
What is tumescent liposuction?
 Liposuction
removes excess fat from specific areas of the body to improve
its shape and contours. A rigid tube that looks somewhat
like a straw is inserted through tiny incisions in the skin.
The tube is connected to a suction pump and by using a back
and forth motion the unwanted fat is vacuumed out. The tumescent
technique was developed by Dr. Jeffrey Klein in the 1980ís
as a way to make the procedure much safer.
Large amounts of fluid containing dilute lidocaine (for
local anesthesia) and epinephrine (to greatly reduce bleeding)
are gently pumped into the fatty layer through tiny needle
holes in the skin until it is swollen or tumescent. The swelling
of the fatty layer makes it easier to remove the unwanted
fat, greatly reduces bleeding and results in numbness that
lasts up to 24 hours. This numbness allows the procedure
to be done without the need for general anesthesia and greatly
reduces postoperative discomfort. Usually light oral sedation
is used to make the injection of the fluid comfortable.
What is microcannula liposuction?
Microcannula technique is liposuction performed using very
tiny cannulas (the tubes or "straws" used to extract the
unwanted fat cells). This technique was developed by dermatologic
cosmetic surgeons in conjunction with the tumescent technique
of local anesthesia. Since liposuction is quite comfortable
under tumescent local anesthesia and there is almost no bleeding,
liposuction can proceed slowly and carefully.
In contrast, most plastic surgeons perform liposuction under
general anesthesia or intravenous sedation anesthesia. This
requires working rapidly because of the risks of anesthesia.
In addition, bleeding can be significant without careful
and complete tumescent infiltration. So they most often use
larger cannulas, typically 4 to 5 millimeters or larger (about
the size of your little finger).
By using very tiny microcannulas ‚ typically about the size
of a thermometer ‚ there are several advantages: First, the
liposuction can be performed through very tiny needle access
holes. These heal quickly, do not require stitches, and are
essentially invisible when healed. They are so small they do
not require stitches. Second, the microcannulas make for a
more gentle procedure and produces the most smooth and even
result possible. With microcannulas, it is easier to control
the progress of the procedure and minimize the risk of taking
too much fat out of an area. This reduces the chance of ripples,
irregularities or uneven results. In addition, the tiny channels
from microcannulas contract very well allowing the skin to
contract and drape well after the procedure.
At Aesthetics MD, Dr. Van Camp and Dr. Teng perform small and
moderate volume (up to 6 pounds of fat at one procedure) liposuction
using microcannula technique and tumescent local anesthesia
exclusively. Dr. Van Camp and Dr. Teng follow the techniques
developed by Dr. Jeffrey Klein MD, who invented the tumescent
liposuction techniques.
Will liposuction work for me?
Liposuction works best for people who have localized areas
of fat that do not respond to diet and exercise. You need to
be in good health and reasonable expectations. Liposuction
is not a substitute for weight loss but there is no definite
age limit or weight limit for liposuction. It is important
to have realistic expectations about what liposuction will
do for you. It works best to improve your shape: it changes
your "inches" but does not change your "pounds". For example,
removing an amount of fat equivalent to a half-pound of butter
from each outer thigh of a womanís saddlebag areas, or from
a manís love handles, will result in a dramatic improvement
in appearance of these areas but it does not significantly
change the personís weight.
Dimples, ripples, and cellulite may remain unchanged or be
only moderately improved with liposuction. Liposuction sculpts
bulging areas into more attractive contours. During your consultation
visit before surgery, Dr. Van Camp and Dr. Teng will discuss
the procedure with you and relate what you can realistically
expect. Possible complications, risks, alternative treatments
as well as the benefits will be fully discussed. Before and
after photographs are usually taken to help evaluate the amount
of improvement.
Facts about fat.
Body fat on an adult tends to increase gradually over the
years. After 30 years of age an individual tends to add fat
according to a genetically predetermined pattern. This fat
pattern is often resistant to change by diet and exercise.
Examples of this are the pouches of fat beside the chin called
jowls, the "love handles" above the hips on men, and the "saddle
bag" accumulations of fat on some womenís upper thighs. For
many people, liposuction is the only realistic means of changing
the bodyís silhouette. In effect, liposuction is the equivalent
of being able to focus the effects of dieting to specific
areas of the body.
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Which areas can be treated?
At Aesthetics MD we most often treat fat accumulations in the lower face (including the jowls, cheeks, and chin areas) and the neck. The most frequent body areas treated in women include: stomach, thighs, hips, "saddle bags", buttocks, neck, and the knees. For men: it is most often the "love handles", abdomen, breasts and the neck and chin.
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Does the fat stay away permanently?
Yes it does. Fat cells removed by liposuction do not grow back. You have all the fat cells you are going to make in your life by the end of puberty. When you gain weight, you expand fat cells that you already have. Tumescent liposuction permanently removes fat cells. If you gain weight after liposuction, it will go to the fat cells remaining in your body in areas where you have not had liposuction rather than ballooning out those old troublesome areas.
Will I need a second or follow-up procedure?
Usually one procedure is all that is needed for a treatment area. A few patients may benefit from a fine-tuning liposuction procedure 6 months to 1 year later. Virtually no blood loss and no need for transfusions
What about the blood loss?
As a result of the blood vessel constriction from the epinephrine in the anesthetic solution, there is very minimal bleeding during and after surgery. There is no need for blood transfusions. The average blood loss is just about a tablespoon (15 ml.) ‚ less than is often taken for blood tests.
What about the safety of liposuction?
The greatest dangers of traditional liposuction surgeries have been shown to be related to 3 factors: The risks associated with general anesthesia and/or deep IV sedation. The risks associated with blood loss and fluid replacement. The risks associated with excessive liposuction (megaliposuction). These major risks are reduced or eliminated by adhering to the tumescent technique.
The drugs used for general anesthesia are relatively more dangerous than those used for local anesthesia. The risks associated with these medicines including respiratory arrest and allergic reactions to them are eliminated by not using them. Local anesthesia is considerably safer. And tumescent liposuction provides better comfort. (Usually only plain Tylenol is needed during healing.)
The risks associated with substantial blood loss during traditional liposuction are eliminated by using the tumescent technique. The amount of fat removed in any one surgery needs to be strictly limited for safetyís sake. At Aesthetics MD we limit the fat removed to moderate amounts and adhere to the guidelines for tumescent liposuction established by the American Society for Dermatologic Surgery. Safety is our first priority.
How is the skin affected?
Because the microcannulas are so small, they make very tiny tunnels through the fat. This leaves many normal fibrous connections between the skin and the underlying tissue. These fibrous connections retract during healing and maintain the skin in its natural position. After liposuction with the tumescent technique one does not have to worry about the excessive folds of skin in the area. Many patients who would have to have a tummy tuck with previous methods, can now have very good results simply through liposuction. This is also true in the neck area, as long as pre-existing skin laxity is not excessive.
How quickly can I return to normal activities?
By not using stitches to close the tiny incision sites there is an accelerated rate of healing and decreased bruising. The tumescent fluid will drain out of the tissues rapidly. This has a dramatic effect in reducing bruising and swelling after surgery. Moreover, there is less inflammation produced so healing is accelerated. Many patients are able to return to light exercise activities like jogging or golf within a day or two after surgery. There is some soreness in treated areas but most patients find this to be quite moderate.
Liposuction is not appropriate for everyone. You will receive full information about tumescent liposuction, including possible risks and limitations, and how it might help you, at your consultation before scheduling any treatment.
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