LIPOSUCTION

LIPOSCULPTURE

Liposculpture refers to contouring the body by the use of liposuction. Inesthetic deposits of fat at certain areas of the body are eliminated, including face and neck, arms, trunk, abdomen, buttocks, hips and thighs, knees, legs and ankles. Liposuction is not for weight reduction, but for getting rid of located deposits of fat that do not respond to diet or exercise. The aspiration of fat can become by means of aspiration (CONVENTIONAL LIPOSUCTION), ultrasounds ( ULTRASOUND ASSISTED LIPOSUCTION ) or the new cannula of POWER ASSISTED LIPOSUCTION. The instrumentation is not whatsoever as important as the judgement and technique of the surgeon . The technique that better results has given us is the superficial detachment of the skin, so that an internal scar takes place remodelling the skin from inside.

Liposuction can be performed like a primary procedure to improve the corporal contour, or in combination with other surgical techniques, like face lifting, abdominoplasty, or lifting of thighs, to tighten the relaxed skin and supporting structures. The best candidate for a liposuction is the person with relatively normal weight that has an excess of fat in determined areas of the body. In case of skin flaccidity, additional surgical procedures may be necessary to eliminate and to tighten the excess of skin. In any case, the lipectomies are being performed not very often. A superficial liposuction as defined by Gasparotti offers great results since it favors the cutaneous retraction. The irregularities of the corporal contour due to structures different from the fat cannot be improved with liposuction.

ANESTHESIA

It depends on the number and extension of the zones to treat. It can be local, local plus sedation, epidural or general. In all cases the blood loss is kept to a minimun by infiltrating first with the Klein's formula.

ZONES TO TREAT

Neck : the turkey gobble can be managed by liposuction. Usually it is associated to lifting .

Arms : Traditional excision of fat in this area, leaving a conspicous scar is rarely performed nowadays. With liposuction, we have extirpated great amounts of fat (1000 cc) with a very good cutaneous retraction. It only needs particular postoperative rules to ease the retraction of the skin.

Abdomen: in young patients or with good cutaneus elasticity the leftover fat can be eliminated with liposuction alone. If there is muscular weakness (diastasis of recti) due to either previous pregnancies or surgeries or where there is a great excess of skin (ie after massive weight loss) the open surgery is the solution ( abdominoplasty) .
Back : In many occasions we associate it to the liposuction of abdomen.

Hips and buttocks : it is the most popular area to treat. The important thing is to contour, to perform liposculpture. In order to obtain a good retraction of the skin it is necessary to suction very superficial leaving the skin very thin. At the same time the buttock is contoured, redefining the folds to give a more youthful look.

Knees : it is possible to eliminate the fat in the inner and frontal aspects of the knee.

Legs : Mainly at the level of ankles and also to contour the posterior aspect of the legs.

POSTOPERATION

Liposuction has few risks if the technique is well known, performed by a Specialist in a recognized clinic. The results are not immediate either. After the operation, imflammation and edema take place which is dealt with is to deal with compressive bandages or garments, much massage (lymphatic drainages) and exercise. The result is not seen at 24 h. nor the week, but reduction of the volume causes a gradual retraction of the skin. By the month it is usual to have lost one or two sizes.

The commonest complication ,although rare, of liposuction are small irregularities in the skin that disappear with massages. Infection is extremely uncommon and skin hematomas dissapear in 2-3 weeks.

Dr. J. Benito Ruiz, 1998-2000