LIPECTOMY means removal of fat by surgery. In liposuction, the surgeon loosens and removes the fat from an area by using metal tubes connected to a suction machine or suction syringes. The suction tubes are usually made of stainless steel. The tips are blunt. The tubes have holes near the tip. The suction machines used for this purpose create powerful negative pressures. Liposuction was started in France in late 70's and since 1981 is extensively in practice in the United States, the U.K and other parts of the world.
The Classical Mayo technique is still in use in most of the centres around the world including India. But the new Tulip liposuction, which was introduced in the UAS in the late 1980's is being used more frequently now. The Tulip liposuction technique is a newer, modern and safer technique. Here, instead of large noisy suction machine, a hand operated syringe device is used. This newer technique uses thinner cannulas and is more accurate. It also causes less tissue injury. We have been using this latest Tulip liposuction in all of our patients-with very good results.
Uses of Liposuction:
Liposuction is mainly used for cosmetic purposes, improving the shape and appearance of the abdomen, buttocks and thighs by removing localized or generalized fat collections from these areas. The arm, face neck, leg, knee and ankle may also be benefited from liposuction. It may also be used while doing other cosmetic procedures such as abdominoplasty, face-lift or breast reduction. Liposuction may be easily carried out during other non-cosmetic operation e.g. appendectomy hysterectomy, etc.
Can one's weight be reduced by this operation? who is a good candidate for liposuction?
Liposuction is neither a substitute for dieting nor a cure for obesity. It is a procedure for body reshaping rather than weight reduction. Healthy elastic skin has the capacity to shrind after liposuction. Even though liposuction can be done on patient's upto any age, it is not normally done if the skin is very loose in a particular area.
For pendulous abdomen where there is extreme sagging due to laxity of the abdominal wall, Abdominoplasty operation is the answer. Here a portion of the skin and fat from the lower abdomen is removed and abdominand muscles are tightened to give the patient a "flat", abdomen. The umbilicus also needs to be reconstructed or relocated in abdominoplasty operation.
The fat cells that are suctioned are removed forever do not come back. Most of the fat cells are situated under the skin. The total number of fat cells present in a person's body does not increase in number. When a person gains weight, the size of fat cells increases as more fat is deposited in it. When one loses weight, the fat is mobilized out of the fat cells and so these cells become smaller in size. Fat cells cannot regenerate of multiply. And so, the fat cells that are removed are removed forever.
The result of liposuction is therefore permanent. Fat does not recollect in the treated areas even if one overeats. But it is advised to stick to a healthy dietary habit after liposuction, because fat can collect elsewhere, Daily exercise such as walking for half an hour is also advised.
Apart from cosmetic uses, liposuction has other uses also. Lipoma (fatty tumor) can efficiently be extracted through a small hole by this technique. Gynaecomastia (enlargement of male breasts) may also be treated by liposuction. Under both the above circumstances, an open operation and a scar and be avoided.
HDL (the protective fat in the body) level was found to increase in patients undergoing liposuction. This increase in HDL level decreased the risks of eardiovascular diseases. It therefore implies that people under going liposuction will be at a lower risk of getting heart attack, myocardial infraction and paralysis from strokes. The relationship of liposuction and managrement of diabetes mellitus is also interesting Glucos tolerance and insulin requirement in dabetes patient has also been shown to improve in some studies. Of course in potential diabetes if liposuction is carried out in a particular time of his/her life the individual may not develop diabetes at all. Liposuction does not produce any change in sex hormone level. It does not interfere with subsequent pregnancy.
Saline containing special medicine is injected into the fat minutes before liposuction is carried out. This medicine and saline loosens the fat and facilities the procedure. A small incision less than 5 mm is made, a few inches away from the area to be suctioned and the suction cannulae inserted. The cuts are so small that stitches are not required and no scar is visible. Depending upon the areas to be suctioned and recontoured or reduced, anywhere from 500 grams to 3000 grams of the material is removed in one sitting. This procedure can be done under general, local or spinal anaesthesia.
After the Surgery:
After the surgery, tight dressing will be applied for 5 to 8 days to promote the shrinkage of the skin and to minimize the swelling. One could feel localized areas of firmness in the suctioned areas for 3 to 6 weeks after surgery. One may require pain medication and antibiotic by mouth for a few days after the surgery.
Discolouration may occur rarely but disappears completely within a few days. Hospital stay required only for those patients who are undergoing liposuction in the evening. Patients undergoing the procedure in the morning can easily go home in the evening. Even after multiple area liposuction, one should be able to up and around in 1 to 2 days.
Result depend upon the expectations of the patient and the amount of fat that is suctioned from the given area. Usually, patients with good elastic skin and who come for recontouring a particular area are very happy.
Article Courtesy By:
Prof. Dr. Sayeed Ahmed Siddiky
FRCS (Glasgow) FCPS (Surgery) FICS, FACS (U.S.A)
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