Liposuction / Liposculpture

Liposuction, also known as liposculpture, reshapes specific areas of the body and removes excess fat deposits, improving body proportions.

The term liposculpture is designed to the modeling of the body outline by combining the removal of fat and using this same tissue in other place to fill a depressed area (fat graft). The great advantage of this operation is that the surgeon has the ability to remove relatively large quantities of fat through small incisions. It is a procedure that aims the fat removal or the elimination of localized fat in a determined area.

Despite good health and physical exercise practice, some people may, also have a body with disproportional outlines due to localized fat deposits. These areas may be due to genetic characteristics, the lack of weight control or physical activity. The liposuction can be used to treat fat deposits in various parts of the body, including thighs, arms, neck, waist, back, medial part of the knee, chest, cheeks, chin, legs, and ankles. In some cases, the liposuction is performed isolated, but it may be performed with other plastic surgery procedures such as facelift, breast reduction or abdominoplasty.

The liposuction is not a treatment for obesity and does not substitute physical exercise practice and good eating habits. Individuals with fat areas in the body and that exercise regularly are the best candidates for this procedure.

Who is it indicated to?
If you are bothered by excess fat accumulation - located anywhere of your body - and do not see positive results with diet or physical exercise, liposuction may be right for you.

• Adults, with 30% of their ideal weight, that have firm skin and with good muscle tone;
• Healthy individuals who do not have life-threatening disease or medical conditions that can harm the cicatrization;
• Nonsmokers;
• Individuals with a positive attitude and realistic expectation of surgical outcomes;
• Individuals determined to follow the recommendations of the plastic surgeon.

Preoperative
In the preoperative, you must:
- Avoid weight-loss drugs on the 10 days before surgery, and aspirin or derivatives 1 week before surgery. Alcoholic beverages should not be ingested since the previous week;
- Provide in anticipation the acquisition of a tight modeling girdle or elastic bands recommended;
- Take to the hospital light clothes and easy to get dressed, besides the abdominal modeling girdle or truss;
- Do depilation, if necessary, on the day before the surgery.

Anesthesia
In general, anesthesia has been general. According the case, the anesthesia can be local with sedation or epidural with sedation by anesthesiologist.

Based on texts by SBCP.

Operation
Depending on the number of areas and liposuctioned regions, the duration of the procedure will be, on average, 1 to 3 hours. The liposuction is performed through small incisions, imperceptible. First, a sterile liquid solution is infused to reduce bleeding and trauma. Then, a cannula is inserted through these incisions to release the fat excess, using a controlled movement back and forth. The displaced fat is then, suctioned out of the body, using a surgical aspirator or syringe attached to the cannula.

Postoperative
The postoperative evolution is calm, since there are no major unforseens the movements; pain sensitivity is not very significant. The feeling is hurt skin by traumatism and can be taken care of with the simple use of common painkillers for about 4 days. Post-surgical stage requires the use of modeling girdles or elastic bands for a period of about a month, relative rest for a few days, proscription to sports for a certain period, and avoid direct sunlight exposure for a month.

- Immediate period: It is the first and second weeks, which are common ecchymosis and edema (swelling). Sometimes the edema may be so intense that there seems not to be an improvement, without this being pathological.
- Mediate Period: Until the sixth month. It is the stage that the edema and, if there is hematomas begin to disappear, the skin becomes irregular, filled with elevations and areas somewhat consistent. These areas gradually regain their normal consistency.
- Late Period: After the sixth month. The skin and subcutaneous reacquire the aspect and normal consistency. We can evaluate then if there is accumulation of fat that needs further intervention or retouching. When necessary, these interventions usually are minor and usually under local anesthesia in the clinic without needing hospitalization.

Caution
Among the care in the postoperative period, you must:
- Keep relative rest for 4 days and avoid physical efforts for 1 week;
- Use the abdominal modeling girdle or elastic bands permanently for 1 month. After, more two weeks during the day;
- Maintain normal diet;
- Bathe in the shower from the second day. When possible, immersion baths or hydromassage from the fourth day.

Observation:
- Dressings and stitches removal (when required) will be done in the clinic according to previous guidance;
- Gentle massage with moisturizing cream can be done from the fourth day;
- Physical activity can be performed gradually after 2 weeks as the patient feels in conditions;
- Sun exposure after 1 month.

Scar
The scars from liposuction are small and approximately one centimeter. They are placed in the most hidden places depending on the suctioned area. The improvement in body contouring will be apparent when the swelling and fluid retention decrease. With continuous practice of healthy diet and physical activity, the loss of adipose tissue in excess should be preserved. Remember that, afterwards, substantial weight gain can change the result obtained with the surgery.

Important: Do not rely on information from well-meaning friends. Get the necessary information directly from the doctor and you will avoid having doubts and anxiety in the postoperative period.

Liposuction is the only way to eliminate fat cells in a controlled and consistent way, but it should be seen as any surgery, with all the care inherent to it.
It is indicated to treat areas of localized fat, which are nothing more than body regions where there is a number of fat cells grouped higher than in surrounding areas, so the salience in body outline. It does not replace weight loss or physical activity; the opposite, they are associated and complementary to a better result.
Besides being the only one, it is the most effective resolution for localized fat and has its consecration by allowing rapid postoperative where there is practically no restriction of movement. It even allows a return to normal activities in a short time and does not leave large scars.
In general, the surgery is performed under general anesthesia, with an average duration from one to three hours, depending on the areas to be treated, with discharging predicted to the same day of hospitalization. What will limit the patient in the postoperative period is the degree of discomfort and pain (to a greater or lesser intensity, depending on the treated areas), swelling and bruises, besides having to wear tight elastic fabric full time for a month and a half.
I always insist that a good plastic surgery is the one that does not leave marks and is not noticed; it is also important in liposuction, because it is not unusual the presence of irregularities and “adherences” on the skin in liposuction operated patients, which should not happen. A good way to avoid this and solve the problem of localized area is the surgeon just suck what is the fat excess, causing to obtain the outline and uniformize the liposuctioned area. Therefore, the most important in a liposuction is not how much fat is removed, but what is left.

Liposuction is one of the most performed procedures of plastic surgery because it can be performed in many areas of the body. However, what draws attention in the appointments is the fear about it. Liposuction is a surgical procedure as safe as other surgeries, but as you can treat many regions at the same time or even associate with other surgeries, this, naturally, will increase the chance of complications and risks. Therefore, the important is the careful surgical program that is not too extensive, requiring good planning and that is well conducted. It is important to highlight again that liposuction should not be performed in order to the patient lose weight, but adjust the body shape that is protruding.