How is this procedure done?

In general, liposculpture procedures use small incisions in the selected area with a high vacuum to remove fat cells. After the fat is removed, the surgeon will stitch (suture) the areas treated and apply a bandage or garment to help redrape the skin and contain the swelling. The "tumescent technique" involves injecting a solution with a local anesthetic into the areas to be treated prior to suctioning. An incision is made near the area from which the fat is to be removed; and a specially designed surgical tube (cannula) is placed through the incision into the fat. The cannula is attached by flexible tubing to a vacuum pump that removes the fat by suction as the cannula is manipulated beneath the skin. Compared to other conventional liposculpture techniques, the tumescent technique is more precise and accurate; there is less blood loss; more fat can be removed and convalescence is shortened. This is an excellent method for adult individuals of all ages with excessive fat deposits, even if you have loose skin.

Ultrasonic Assisted Lipoplasty (UAL) is a new method of liposculpture that uses ultrasound energy to liquefy fat before it is suctioned. Because the fat is liquid at the time that it is removed, liposculpture is smoother and mechanically more efficient. In the United States, ultrasound has been used for surgical removal of tissues other than fat for more than twenty years. Ultrasound is a well-established method in general surgery, neurosurgery and cataract surgery. Ultrasound assisted liposculpture has been in use in Europe for more than ten years.

UAL may be particularly advantageous for suctioning large volumes of fat, for working in fibrous or scarred areas and for skin tightening. It is important to note that UAL does have some disadvantages: The ultrasound probe is larger than the usual tube (cannula) used for liposculpture and requires a slightly larger access incision. Therefore, its uses should be

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How do I prepare for my liposculpture?

During your initial preoperative visit with your surgeon, be prepared to give a complete medical history including all your medications, allergies and previous surgeries. You will undergo a thorough physical examination and blood tests. If you are over age 50, an electrocardiogram may be taken. Photographs are important aids in planning and performing your liposculpture. They become a permanent part of your patient record and are taken before and several months after your procedure.

During your consultation, you will be given specific directions to help you prepare for your procedure. Instructions generally include taking vitamins, cautions about taking certain medication and drinking alcohol, the shaving process and use of antibacterial soap. You must not eat or drink anything eight hours before your procedure. If you take daily medication, ask your surgeon if it is safe to take before your procedure. If you have any sores on your body, if you have a cold, sore throat or allergic condition, inform your surgeon so you may be examined prior to your procedure.

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How long does the procedure take?

Liposculpture generally takes between one to four hours depending on how many areas are treated.

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What form of anesthesia is used?

When only one or two small areas are treated, particularly on the face and neck, you will be given local anesthesia. When multiple or large areas are treated, general anesthesia, intravenous sedation or epidermal anesthesia is used and an expert anesthesiologist M.D. (medical doctor) is in attendance.

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Can I return home the same day?

Generally, yes. If you are having small amounts of liposculpture, you must make arrangements for someone to pick you up, take you home and stay with you for the first 24 hours. When larger amounts of fat are removed, your surgeon may suggest that you stay overnight for observation. Your surgeon will help you decide what is the best option for your particular situation.

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What precautions should I take during my recovery?

You are placed in a support garment immediately after surgery that you will wear night and day for one to three weeks. You will be given instructions to follow including deep breathing exercises, diet, bandage care, bathing, showering, driving and exercising. Some surgeons recommend that you take an iron supplement preparation before and after your liposculpture.

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How long before I can return to normal activity?

Most people return to work and their usual activity within a week, depending on the extent of the areas treated.

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What are some of the complications that can occur with liposculpture?

Serious complications are uncommon with this kind of procedure. All individuals have bruising which may last two to three weeks, occasionally longer. A certain amount of numbness or reduced sensation in the treated area is also to be expected. As with any surgical procedure, bleeding, infection and other complications are possible.

Some people may experience shaping irregularities in the treated areas following the procedure. Usually this is temporary, but occasionally may be permanent. Perfect symmetry is a desired goal although small side to side differences can occur. Your surgeon will make every effort to give you as smooth and even a result as possible. Nonetheless, it is important to enter into your procedure aware not only of the benefits, but also of the possible complications. Talk to your surgeon about every question and concern you may have.

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What can I expect immediately after my procedure as well as later on?

You will experience some discomfort for an hour after the procedure for which you will be given medication as necessary. There is usually little discomfort thereafter although you will have a prescription for pain medication should you need it. Your stitches are painlessly removed five to seven days after surgery.

You will immediately see the reduction in your fatty bulges-even though it may take two to four months for the swelling to completely disappear. In most individuals, liposculpture scars are about one to two millimeters in length and barely visible. Your scars will be red or pink for six months and gradually fade thereafter. The scars are rarely troublesome. Nevertheless, you should know that all scars are permanent and their height, width, and final color are not totally predictable.

Five percent of men and women have secondary liposculpture or a "touch-up" after six months, most frequently for removal of additional fat. You will be happiest with your procedure if you recognize that it will take several months for the appearance of your final, new sculptured look.

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