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JG a 45 yo could not get rid of her abdominal, flank and hip fatty areas despite diet and exercise.
Tumescent power assisted liposuction removed over 4.5 pounds of fat from the areas described.
The cause of obesity and localized fat deposits is a subject of intense debate today. It may be that the obese patient has a more efficient metabolic system. In addition, there is evidence that certain areas of the body, (i.e. stomach, thighs, hips) possess fat cells that attract calories faster than other areas. Thus creating a predisposition for fat accumulation referred to as lipodystrophy. These areas appear to be more resistant to exercize and diet programs. The ideal candidate for liposuction is the individual with these localized, fatty deposits in an otherwise satisfactory physique or figure. These areas are generally confined to the arms, flanks, abdomen and thighs in women. In men the areas are love handles, abdomen and breasts (gynecomastia). The average removal of fat has been approximately five pounds. However, in some patients as little as a half pound or as much as 20 punds have been removed depending upon the areas involved. While liposuction is not generally indicated in the obese patient, certain areas may be improved thus giving this individual encouragement to lose weight. In general, however, the markedly obese patient is referred to a dietitian, trainer, and gym to begin a weight reduction regimen and then return for an evaluation.
Cellulite occurring in the thighs is a condition caused by tight, band like internal connections between the skin's surface and the underlying muscle layers. Cellulite will not be improved with liposuction
Any patient over forty may be asked to see their internist for medical clearance. Special tests will be requested to insure that the patient is healthy and that there will be satisfactory healing. Smoking and aspirin ingestion are prohibited for two weeks before and two weeks after surgery. Aspirin will cause more bruising and bleeding, thus prolonging the recovery period. Smoking has been found to lead to delayed healing and more noticeable scars. Occasionally, a hyperbaric oxygen treatment is recommended in those patients who are smokers, to prevent these complications. You will be given prescription for homeopathic and pharmaceutical preparations to prepare your system for surgery.
On the morning of surgery you will enter into our Nova Surgicenter through a private, discreet entrance. After routine charting, you will meet with Dr. Sokol who will examine your lipodystrophic areas and with your input, mark out a treatment plan to be followed in surgery. These marks will stay on during the procedure and serve as guides for the proper, symmetrical and safe removal of fat. Thereafter, our anesthesia staff will assist you into our operating room and apply the necessary monitors before you fall asleep. The operation's length will be determined by the amount of fat to be removed. Generally our procedures last from 1-3 hours. They are performed using a combination of Ultrasonic and Tumescent techniques. All incisions are placed in hidden areas or in as inconspicuous locations as possible. With the new techniques discussed above there is little risk for significant blood loss requiring a transfusion. However, when large amounts of fat are to be removed, (in excess of 15 pounds), or when liposuction is combined with other Plastic Surgery, the patient may be advised to donate one or two units of his/her blood for replacement during the procedure. This has been helpful in healing more quickly and allowing the patient to return to work or social schedules at an earlier date. Following surgery, you will be placed in a compressive garment that will help to prevent swelling post operatively. Occasionally, a urinary catheter will be utilized during surgery to monitor your urine output. This is especially true, when the removal of fat exceeds ten pounds or the operation requires more than three hours to complete. This catheter may be left in overnight to insure your rest and continue the monitoring of your fluid intake.
Many patients elect to use an aftercare facility in a nearby hotel. These are fully staffed with 24 hour expert nursing care. All patients using these facilities have had cosmetic surgical procedures. Thus the nurses are experienced with the needs of this surgery and highly attuned to your privacy and comfort. Meals and transportation to your postoperative visits are provided. You will be seen by the nursing staff the next day for a dressing change. If you live less than one hour away from the office, you may wish to go home with a nurse which will be arranged for you. If you have a family member or friend that can devote the time to you, this may be a preferable aftercare situation for you. Nearby hotels can be utilized if you prefer. We recommend at least a one night stay, if you live more than one hour away from the office.
Many patients experience little or no pain following liposuction . Everyone is different and you may feel some discomfiture during the first 24 to 48 hours. Most patients have told us that the pain feels like that of a "charley horse," or sore muscles after a vigorous work out using new or unused muscles. You will be provided with a prescription for pain pills that will assist you.
It is recommended that for the first 3-4 days that you sleep on your back in a comfortable position creating as little pressure to your operative area as possible. No exercise, intimacy, emotionally charged situations, smoking (14 days) or alcohol is permitted for the first 7-10 days. This will insure a safer, shorter recovery period, without increased bruising or wound healing problems.
Your results will be partially seen after your dressing is removed on the third day. You will still be bruised and swollen as it takes 10 to 14 days for the majority of the swelling and discoloration to disappear. You may be asked to visit a physical therapist for ultrasound and massage treatments. These treatments reduce the bruising and swelling more quickly than if left alone. The stitches are removed on day 4-6. The compression binder, girdle or sleeve is worn, night and day for 7 days and daytime only for an additional week or two. It is important that you set up a date with a friend or relative on day 7-10 for an outing, dinner or movie. By that time all your stitches will have been removed and you will be starting to walk and move normally. You will look forward to getting out of the house. Your final result will take approximately one month to occur, although you may see changes during the first year. Numbness in the operative area, especially around the incision sites is normal for the first 6 weeks to three months. This will eventually disappear. Avoid any sun exposure to your operative areas for at least three months. Thereafter, you must use a #15 or higher sunscreen.
While there are risks to any procedure, in the carefully prepared patient, liposuction should not cause any significant problem. Liposuction is the most frequently performed Plastic Surgical procedure in the U.S. today. Occasionally a patient may notice some indentation, persistent fat deposit, or skin discoloration postoperatively. Please bring this to the attention of our staff. In all probabilities, these findings will disappear in time; if not, minor revisions may be required. Fluid accumulations, skin burns, and over corrections have been seen with ultrasonic liposuction. While these may require secondary treatment, we have not experienced any permanent unfavorable results with seromas and have not seen burns and excessive removals in our own patients. |
Historically, liposuction has
been around for more than 20 years, beginning in France with Dr. Henri Illous.
Dr. Sokol was personally trained in the Illous technique. Over the years
there have been many changes in the technique and equipment. The basic underlying
concept has remained the same, the vacuum removal of unwanted fatty deposits.
The procedure utilizes the Tumescent and Ultrasonic techniques. Tumescent
Liposuction refers to the instillation of specially prepared solutions to
reduce the blood loss and risk of the procedure while increasing the amount
of fat that can be safely removed. The addition of Ultrasonic Liposuction
further reduces the blood loss and enables the surgeon to remove fat more
efficiently. The combination of these two techniques has increased the effectiveness
of Liposuction and improved long lasting results. Patients heal faster with
less discomfort and bruising while returning to work and exercise at an
earlier date.
We recommend General Anesthesia
for our patients, so that there is complete rest, safety, and no discomfort
during the procedure. During the procedure you will be receiving carefully
measured amounts of fluid to assist in the removal of fat while reducing
blood loss. These fluid amounts will be tracked with your pulse, urinary
output and vital signs to make certain you are receiving the proper amount.
Position changes during surgery and anesthetic requirements are all easier
and safer with a General anesthetic. You will have an opportunity to meet
with our Anesthesia staff and discuss this aspect of your surgery.
