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Liposuction Results
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Question: What are peoples' personal opinions on liposculpture/suction and
other lipo* procedures?
Is it just for wealthy cheats who are too lazy to burn off their own
fat or is it a useful way of removing those extra fat cells after you
have reached your goal weight?
Is it something you do instead of dieting or in addition to dieting or
as a prelude or finale to dieting?
Now I know for any specific medical issues I must consult the best
practitioner available - but I'm really interested in people's
personal opinions on the matter, particularly if you have had any
procedures done yourself.
What's your ideas or opinions?
Answer: The history of liposuction is such that it first became popular in
France & was performed by Dr. Ilouz. He infiltrated the tissues with
fluid & then suctioned out the fat under general anesthesia via
incisions hidden in skin creases. This was followed by a period of
greater reliance on general anesthesia & less infiltration. Then came
a period of greater reliance on infiltration with fluid mixed with
local anesthesia. And if some is good more must be better philosophy
ensued so a very high volume of fluid was then infiltrated. This made
the area to be suctioned swollen & hard hence the term tumescent. The
idea behind this was to perform the procedure without general
anesthesia or an anesthesiologist to allow the patient to recover more
quickly or leave the surgery center earlier & cut costs. Another
reason not usually mentioned is that early proponents of this
technique were not surgeons, did not have operating room privileges &
could not get anesthesiologists to anesthetize these patients for
liability reasons. The infiltration of larger amounts of fluid
probably does decrease the amount of postoperative bruising & pain.
However, because body contours are severely distorted the practitioner
has to be more experienced to gauge where & how much fat to remove in
order to obtain a specific result. Also, with the greater reliance on
infiltrated fluid for anesthesia shorter & narrower liposuction
cannulas had to be used & applied closer to the surface.
Ultrasonic assisted liposuction has been introduced over the last
couple of years. Initially a solid cannula was introduced & ultrasonic
waves used to emulsify the fat which was later suctioned out with a
hollow metal cannula. Later the ultrasonic cannula was hollowed to
allow both emulsification & suction at the same time. Initially it was
thought that ultrasonics resulted in less bruising, less blood loss,
greater skin shrinkage & less surgeon fatigue in performance of the
procedure. It has seen been proven that there is very little
difference in bruising or skin shrinkage. Ultrasonic assisted
liposuction results in more noticeable liposuction access site scars,
increases the length of the procedure & in inexperienced hands can
result in skin burns. My current personal preference is to reserve it
for patients who have had prior liposuction or have large volumes of
fat to be removed.
In summary be careful about the use of the word tumescent as some
people use it to denote slightly different techniques with vastly
different results, some of which can be very unsightly. I prefer to
use a wet technique rather than true tumescent placing the access
sites so they will be hidden in skin folds. Lastly, the end result of
any liposuction is dependent more on the condition of the overlying
skin immediately after the procedure than the volume of fat removed.
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