- Result of liposuction is depends on skill and care of surgeon not the machine.
Liposuction is operation which removes fat cells. But goal of the operation is not weight loss or Obesity cure.
But liposuction is helpful surgery for patients with high blood pressure or diabetes
- liposuction instruments
Doctors Giorgio and Arpad Fischer, two Italian-American surgeons working in Rome, Italy, invented the liposuction procedure in 1974. The roots of liposuction, however, date back to the 1920s. Relatively modern techniques for body contouring and removal of fat were first performed by a French surgeon, Charles Dujarier.
In 1985, Klein and Lillis described the "tumescent technique", which added high volumes of fluid containing a local anesthetic allowing the procedure to be done in an office setting under intravenous sedation rather than general anesthesia. Concerns over the high volume of fluid and potential toxicity of lidocaine with tumescent techniques eventually led to the concept of lower volume "super wet" tumescence
In the late 1990s, ultrasound was introduced to facilitate the fat removal by first liquefying it using ultrasonic energy. After a flurry of initial interest, an increase in reported complications tempered the enthusiasm of many practitioners.
Technologies involving the use of laser tipped probes (which induce a thermal lipoysis) have been introduced in recent years and are being evaluated to examine any potential benefit over traditional techniques.
In 2005 laser assisted liposuction was introduced, and it is advertised that this method helps to improve skin elasticity. But there is no strong evidence to support this
- Preoperational instruction of liposuction
01.Patient’s information including weight change, pregnancy and diet must be checked.
02.Whole body is examined in order to figure out posture, spinal curvature and body line.
If asymmetrical part is detected, inform it to the patients. Patient’s tends to check their body thoroughly after operation.
Patients and clinic are able to avoid misunderstanding.
03.Find the body part which has most fat. Body parts like thighs and
abdomen is very effective area.
04.Expectation of patients – Clinic need to explain patients also need to understand liposuction alone
can not give the result they want, it always need to accompany with diet and exercise.
- Surgical instruments
Cannula is thin tube used for liposuction.
There are little holes at the end of cannula, suction is made
through that holes. Fat goes through flexible tube then finally
it goes to collection bottle.
2~2.5 mm cannula is used for liposuction on face and neck.
2.5~3.0 mm cannula is used for thighs and abdomen.
Power-assisted liposuction (PAL) is very helpful for liposuction.
Cannula moves 2~3mm back and forth and it moves 3000 times per
minutes to take out fat cells. This minimize tissue damage and helpful
for delicate work
Ultrasonic waves and laser also can be used but there is not advantage in this. These equipment delays operation time also elevates risk of dermolysis. Surgical result is depends on surgeon’s skill and care, it is not depends on machine
- Surgical method : Preoperational check up
When patient arrives in operating room, surgeon starts design on patient’s body. Then photo of patients is taken to show on monitor. Disinfect the patient’s skin with standing position.
Operating table is covered with surgical sheet. When patient lay on bed, bleed pressure, E.C.G, pulse oxymeter, compression garment for prevent vein thrombosis is attached on bed. Only surgical site is exposed and rest of the body is covered with surgical draping
General anesthetic is used for most liposuction.
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- Surgical method : Operative procedure
Tumescent solution is injected on operation site. Composition of tumescent is 1000ml of lactated ringer’s solution, 25ml lidocaine, 1m epinephrine. If 2000cc fat needs to be removed, 2000cc tumescent solution is injected. Tumescent solution reduces bleeding, cuts down operation time, less pain after surgery. The procedure of operation is below.
Below two photos are before and after photo of liposuction.
Liposuction only removes fatty tissue, but veins, nerves and fiber tissue remains there. Fiber tissue contracts while skin is recovering. Therefore skin does not get saggy even after liposuction
- After care
After operation is finished, surgical site is closed and dressed. Patients wear compression garment.
Patient would walk two hours after operation with help. Stitch is removed 7days later, then exercise is available 3 weeks after operation. Low calorie diet is recommended after operation.
Also low sodium diet (500~ 1000 mg / day ) is required before and after ( one month ) operation
Over correction could occur. Surgery site gets depressed or uneven but this matter can be corrected with fat grafting. Just like other operations, there is chance of bruise, hematoma, scar, infection exist. There is a risk of pulmonary edema if tumescent solution is overloaded. It is important not to overload tumescent solution. Amount of urine needs to be checked through foley catheter during operation