Liposuction Assignment

 

INTRODUCTION

What is Liposuction? Liposu Lip osucti ction on is a surgic surgical al techni technique que that that im impro proves ves the body's body's con contou tourr by removing remov ing excess fat from deposits deposits located between between the skin and muscle. Liposuctio Liposuction n involves the use of a small stainless steel tube, called a cannula (from the Latin word for reed, tube, cane). The cannula is connected to a powerful suction pump and inserted into the fat through small incisions in the skin. Fat removal is accomplished as the suction cannula creates creates tiny tunnels through the fatty fatty layers. layers. After surgery, surgery, these tiny tunnels collapse and thus result in an improved body contour. Liposuction is one of the most most popular popular cosmet cosmetic ic surger surgeries ies that that remove remove unwante unwanted d fat deposits deposits from from specific speci fic areas, including including the abdomen, abdomen, hips, buttocks, buttocks, thighs, thighs, knees, chin, cheeks, neck, chest and upper arms. This procedure has become very popular with women who account for eighty percent of all lipoclastic surgeries. Men seem to be catching on, wanting to eliminate "love handles" around their waist or unwanted fat from their   back or neck.

Definition Liposuction is defined as the removal of fat from deposits beneath the skin using a hollow stainless steel tube, called a cannula with the assistance of a powerful vacuum. Liposuction can be accomplished either with the use of general anesthesia, or with heavy IV sedation, or totally by local anesthesia.

Why do Liposuction? Liposuction can remove fat that patient have not been able to shift with diet or  exercise. The fat cells will not be replaced by your body, so there should be a long-lasting change in your body shape, especially especially if you exercise, exercise, eat a healthy healthy diet, and maintain maintain a healthy weight after the operation. Liposuction is not a treatment for weight control or obesity and it cannot remove cellulite or stretch marks.

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ISSUES OF LIPOSUCTION AND WEIGHT CONTROL

The Myth Of Liposuction For Weight Loss In a culture that is very much focused on instant gratification, we hold our weight loss up to the same standards, expecting pounds to shed immediately and muscles to be defined with the lifting of one weight. It is no wonder that more and more people turn to liposuction for weight loss – a procedure that rids the body of pockets of fat. But what  people fail to realize is that liposuction for weight loss does not address the underlying weight issue and will not achieve desired results without the use of proper diet and exercise. Liposuction is a surgical procedure that involves the making of several incisions around a particular area of the body that is storing excessive fat deposits. A surgeon then inserts an instrument into the incisions that allows them to vacuum out excess fat. The  procedure, however, is far more invasive then it sounds; the surgeon must aggressively attack fat to remove it from the body and to maintain a consistent and smooth appearance. The liposuction patient – who is most often put under general anesthesia – faces recovery time like any other surgery - and some pain following the procedure. What has been shown is that liposuction works for trouble spots that have not adequat adeq uately ely respond responded ed to proper proper diet diet and exerci exercise. se. An overal overalll health healthy y per person son often often responds well to liposuction if they are using the procedure as a supplement to good nutrition and healthy physical habits. However, liposuction for weight loss in a patient who is overweight, physically unfit, and in the habit of eating poorly will almost always fail. The reason is that liposuction for weight loss is not a magic bullet. In such a case, the  patient is required to adopt healthy eating habits and proper exercise in order to maintain the look of the liposuction.

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THE IMPORTANCE OF WEIGHT CONTROL

How do I determine my ideal weight? Because healthy people come in all shapes, sizes, and weights, many weightmanagement experts now avoid using the term ideal weight— a concept derived from the height-weight tables once used by insurance actuaries—and instead focus on body mass index and waist circumference (or waist-hip ratio). These measurements better represent the degree and/or location of body fat, which is most important in determining health risk. While the number on the scale can provide a general indication of whether a  person's weight falls within a range that is healthy for him or her, the body mass index offerss a more revealing offer revealing look at someone's overall risk of disease and is widely accepted  by all major health organizations for the classification of overweight and obesity. BMI is typically calculated in one of two ways: •

BMI = kg/m2. Weight (kilograms) divided by height (meters) squared

•

BMI = Weight (pounds) multiplied by 703, divided by height (inches) and

divided again by height (inches) Population data indicate that a BMI between 18.5 and 24.9 is considered healthy for most people, while those with BMIs between 25 and 29.9 are considered overweight and therefore at increased risk for developing weight-related illnesses. In general, the higher the BMI, the greater the risk. People with BMIs of 30 or greater are considered to be obese, a category that is divided into three classes based on BMI: •

Class 1 = 30 to 34.9. High risk. Typically 30 to 40 pounds overweight

•

Class 2 = 35 to 39.9. Very high risk. Typically 40 to 100 pou pounds nds overweight

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•

Class 3 = 40 or greater. Extremely high risk. Typically 100 pounds or more

overweight Because the accumulation of visceral fat (internal fat that collects around the organs and midsection) is thought to be associated with higher health risks than fat located elsewhere in the body, waist circumference is another good way to assess weightrelated health risks. In general, men whose waists measure more than 40 inches and women with waist circumferences larger than 35 inches are at greater risk for many serious medical conditions than people who are smaller around the middle. Weight-management recommendations

Experts offer the following general suggestions to people striving to manage their weight: Eating and drinking : •

Keep in mind that foods that are heart-healthy are usually weight-friendly, too.

•

Add more healthful food choices to your pantry, and remove less healthful

ones. •

Drink plenty of water, and eat a variety of fresh fruits and vegetables.

•

Eat only when you're hungry.

•

exercise   portion portion control. control. Know what proper portions of food look like, and exercise

•

Control between-meal snacking.

Significantly reduce your intake of calorie-dense foods (those with high fat and/or sugar content that leave you hungry). •

•

Cut back on or eliminate sugary drinks.

Tailor your eating to something you can stick with and that makes you feel satisfied. Remember that there are many ways to eat healthfully. •

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TECHNIQUES OF LIPOSUCTION

There are various techniques for doing liposuction. Some techniques are now longer lon ger conside considered red safe safe (Dry (Dry Techni Technique) que),, and some some are recogni recognized zed as worldworld-wid widee standards of care (Tumescent Technique). These are the list of liposuction techniques and explanations : Tumescent Liposuction Lip osuction

The word "tumescent" means swollen and firm. By injecting a large volume of very dilu dilute te li lidoc docai aine ne (loca (locall an anes esth thet etic ic))

an and d ep epin ineph ephri rine ne (c (capi apill llar ary y

co cons nstr tric icto tor) r) in into to

subcuta subc utaneou neouss fat, fat, the target targeted ed tissue tissue becomes becomes swolle swollen n and fir firm, m, or tumesc tumescent ent.. The tumesc tum escent ent liposu liposucti ction on techni technique que is a method method that that provid provides es loc local al anesth anesthesi esiaa to lar large ge volumes of subcutaneous fat and thus permits liposuction totally by local anesthesia. The tumescent liposuction technique eliminates both the need for general anesthesia and need for IV narcotics and sedatives. The tumescent technique for liposuction : •

•

•

 provides local anesthesia constricts capillaries and prevents surgical blood loss  provides fluid to the body by subcutaneous injection so that no IV fluids are needed

Dilution & Vasoconstriction Produce Safety

Tumescent liposuction totally by local anesthesia has proven to be extremely safe despi des pite te the the us usee of un unpr prec eced edent ented ed la larg rgee doses doses of li lido doca cain inee an and d epine epinephr phrin ine. e. The The explanation for this remarkable safety is the extreme dilution of the tumescent local anesthetic solution. Large volumes of dilute epinephrine produce intense constriction of  capillaries in the targeted fat, which in turn greatly delays the rate of absorption of  lidocai lid ocaine ne and epineph epinephrin rine. e. Undilu Undiluted ted lidocai lidocaine ne and epinep epinephri hrine ne is absorb absorbed ed into into the   bloods bloodstre tream am in less less than than an hour. hour. Tumesc Tumescent ent diluti dilution on cau causes ses widesp widesprea read d capill capillary ary constriction which causes the absorption process to be spread over 24 to 36 hours. This reduces peak concentration of lidocaine in the blood, which in turn reduces the potential toxicity of a given dose of lidocaine. Dentists typically use concentrated epinephrine 5

 

which may cause a rapid heart rate if the epinephrine is rapidly absorbed. When very dilutee tumescent dilut tumescent epinephrine epinephrine is used, the wide spread spread vasoconstri vasoconstriction ction slows the rate of  epinephrine absorption, which in turn prevents preven ts an increase in heart rate. Dry Technique

Dry Technique Dry Technique (no longer used) required general anesthesia. The dry technique derived its name from the fact that it did not use injections of local anesthesia into the fat before liposuction. This technique was abandoned because of the excessive blood loss it caused. Blood composed approximately thirty percent (30%) of  the tissue that was removed by liposuction using the dry technique. Comparing Dry and Tumescent Techniques

The tumescent technique for local anesthesia improves the safety of large-volume liposuction by virtually eliminating surgical blood loss and by completely eliminating the risks risks of general general anesth anesthesi esia. a. All patien patients ts were were treate treated d as out outpat patien ients. ts. There There were were no hospitalizations. There were no transfusions. There were no complications. There were no seromas. The mean volume of whole blood aspirated by liposuction was 18.5 ml. For  each 1000 ml of fat removed, 9.7 ml of whole blood was suctioned. Wet Liposuction Technique

The Wet Liposu Liposucti ction on Techni Technique que also also requir required ed genera generall anesth anesthesi esia. a. The wet liposuction technique required the injection of approximately 100 ml of local anesthesia containing epinephrine. Although the wet liposuction technique caused less blood loss than the dry technique, blood loss with the wet liposuction technique was still excessive and dangerous. Blood composed approximately 15% to 20% of the tissue removed by liposuction using the wet technique.

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Super Wet Technique

Super Wet Technique also requires general anesthesia. The super wet technique requires the injection of a volume of dilute local anesthesia that is less than half the volum vol umee us used ed fo forr the the tume tumesc scen entt te techn chniq ique ue.. Surg Surgic ical al bl blood ood lo loss ss wi with th th thee su supe perr wet wet technique is greater than the tumescent technique but significantly less than the wet tech te chni niqu que. e. Appr Approx oxim imat atel ely y eight eight perce percent nt (8%) (8%) of th thee fl flui uid d re remo move ved d by su super per wet wet liposuction is blood. Ultrasonic Assisted Liposuction (UAL)

Ultrasonic Assisted Liposuction (UAL) requires the use of a large volume of  tumescent fluid and uses either a metal probe or metal paddle to deliver ultrasonic energy and heat into subcutaneous fat. Internal UAL is the term used to describe the technique where a long metal probe, which may be solid or hollow, is inserted into fat through a large incision. Among those surgeons who do internal UAL, most rely on the use of general anesthesia or heavy IV sedation. Internal UAL has largely been abandoned because of the risk of full-thickness skin burns and severe scaring. The initial reports of internal UAL were unrealistically enthusiastic. External UAL requires the use of tumescent fluid and uses a metal paddle applied to the skin and directs ultrasonic energy into subcutaneous fat. External UAL does not improve liposuction results and can cause burns to the skin. Because there is insufficient proof of the safety of UAL devices, the FDA (Food & Drug Administration) has never given approval for marketing and advertising of UAL devices to be specifically used for liposuction.

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Vaser - Ultrasonic Liposuction

Vaser liposuction, also called LipoSelection, is another alternate technology to traditional tradi tional liposuctio liposuction. n. Vaser ultrasonic ultrasonic liposuction liposuction is still still a process process by which fatty deposits are removed from beneath the skin to improve the aesthetics of a particular body   part. part. Optima Optimally lly,, patien patients ts who are treate treated d by Vaser Vaser liposu liposucti ction on are in good good phy physic sical al condition and are looking for a contouring or body sculpturing as opposed to using liposuction as a way to lose weight. So Sound und Surg Surgic ical al Te Tech chno nolo logi gies es,, LLC LLC in 20 2002, 02, in intr trod oduc uced ed va vase serr ul ultr tras ason onic ic liposuction. This FDA technology uses sound waves to gently loosen fat and pave the way towards liposuction and smooth contouring of the body. In the case of vaser liposuction, tumescent liquid, or a saline solution mixed with anesthetics, is injected into the body area being treated. Instead of using a cannula and manual movement to break down the fat tissue, or a laser, or water pressure, vaser  liposuction uses ultrasound high frequency vibration to break fat cells apart. The cosmetic surgeon uses Vaser ultrasonic ultrasonic probes, inserted into the fatty fatty tissue tissue to gently break the fat cells down. The vibration gently disengages and loosens the fat cells and ultimately emulsifies the tumescent fluid that has been infused into the body area. Once the emulsific emulsification ation is in process, process, a small cannula cannula is used to remove the liquid and the fat cells. Some of the local anesthetic remains in the tissue and that helps to reduce post-procedural pain. This process is considered gentler that the more traditional liposuction techniques and ultimately offers your cosmetic surgeon a great deal of control and you get the smooth, contoured look for which you are looking. Additionally, vaser liposuction is specifically designed to loosen fat but to protect and preserve other tissues and by using the

saline

solution

there

is

typically

less

bleeding

and

bruising.

Areas on the body that are especially well suited to vaser liposuction include the thighs, knees, abdomen, love handles, arms, chest, chin and neck.

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Power Assisted Technique (PAL)

Power Assisted Liposuction (PAL) devices have recently become available. PAL devices use power supplied by an electric motor or compressed air to produce either a rapid in-and-out movement or a spinning rotation of an attached liposuction cannula. Advocates of PAL assert that it makes liposuction easier for the surgeon. While some liposu lip osucti ction on surgeon surgeonss have have expres expressed sed enthusi enthusiasm asm about about PAL, PAL, man many y others others remain remain skeptical about any advantages of PAL. There are no objective scientific publications to support the enthusiastic claims made by manufacturers of PAL devices. Laser Lipolysis, Laser Liposuction or Liposculpture

Laser liposuction was developed as an alternative to the manual method used in tumescent and traditional liposuction. It was also developed to help cosmetic surgeons target specific body parts that were difficult to access with the more traditional methods,  but are perfectly suited to laser body sculpting. Laser lipolysis, which is also known as liposculpture and laser liposuction is somewhat different than traditional liposuction. In some techniques of laser lipolysis, suction is used, while in others no actual suction is actually used. Instead of using the cannula to remove fatty deposits beneath the skin, the cannula actually houses a laser and the laser is used to literally melt the fat of the target area away.

Once the fat has been liquefied, it is drained from the body using tiny incisions or  gently suctio gently suctioned ned away. away. The procedu procedure re is consid considere ered d gentler gentler than than other other li lipos posuct uction ion techniques because of the smaller cannula used and because of the smaller size of the incisions. This also means less scarring. Because of the heat used in the procedure, the  body naturally naturally reacts reacts by contracting contracting the tissues near procedure which causes the skin to tighten and become smoother. These lasers are specially designed to target only fat cells, protecting muscle and nerve tissue. This precision often means less pain, faster healing and very little bruising

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after the procedure. Additionally, different companies have created liposuction lasers that use specific wavelength frequencies for optimal results. Laser lipolysis offers the same contouring and visual improvement of traditional lipos li posuct uctio ion n and is ac actu tual ally ly be bein ing g us used ed more more of ofte ten n in sm smal alll ar area eass of tr trea eatm tmen ent. t. Specifically, many liposuction surgeons opt to use laser liposuction on the chin, jowls or  face of a patient because of the precision precision of the procedure procedure and the great success. success. The excess pockets of fat that can develop in this area can be melted with precision and the tightening of the skin operates almost as a face or neck lift. There are a number of  companies who have developed different lipolysis lasers, each of which has a specialty. SmartLipo - Laser Liposuction

Smartt Lipo is actually Smar actually where laser liposuction liposuction began. Brought Brought to the marketplace by Cynosure, the SmartLipo system offers all the benefits of a high quality laser lipolysis system and the benefit of experience in the market. The SmartLipo system has truly been tested and proven successful and is an established technology with an excellent reputation. When a doctor uses SmartLipo, the small cannula and powerful laser offers precise targeting of even the smallest body part. This means a doctor can target pockets of fat that would otherwise be untreatable with traditional liposuction. The laser not only melts the fat and facilitates its removal; it also causes small blood vessels to coagulate coagulate immediately immediately which reduces reduces bruising bruising and the chance of    blood loss. Finally, that same laser stimulates collagen retraction and skin tightening which whi ch are are optim optimal al for for sh shri rinki nking ng the the sk skin in once once fa fatt ha hass be been en melt melted ed an and d re remo move ved. d. SmartLipo is often used in conjunction with cellulite treatments and can be used with only local anesthetic, which reduces patient health complications from general anesthetic.  

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CoolLipo - Laser Liposuction

CoolLipo, like other laser lipo systems is a technology that uses laser wavelengths to dissolve fat and firm the skin. Cool Lipo candidates are in good health and are not planning to use liposuction as a weight loss technique, but rather for body contouring and sculpturing. CoolLipo   by CoolTou CoolTouch, ch, Inc. Inc. is de desi sign gned ed sp speci ecifi fica call lly y fo forr smal smalle lerr ar area eass of  treatment in the face, chin and neck areas. This includes fat deposits that are particularly stubborn and resistant to any kind of weight loss or  traditional liposuction. In these areas on the face, many people assume the only option is a face lift or  neck lift when in fact, Cooltouch Lipo is also a viable solution. The idea is that getting laser lipolysis is less invasive than a full face or neck lift and that the recovery time will  be substantially shorter. Also, traditional liposuction is very difficult to use in these areas of the body because of the small volume of fat and all the other anatomical structures and tissues that need to be protected. The cannula and laser are used in the fatty portions of the jowls, chin or neck to remove, very carefully, excess or fatty tissue. The Coollipo laser is specifically designed to protect tissues tissues other than fat. Because Because CoolLipo is designed for contouring contouring the face and neck, the laser also maximizes the other benefit of laser lipo - the skin tightening and collagen renewal. CoolLipo laser liposuction uses a 1320 nm wavelength that is known to have maximum maxim um benefit benefit for collagen rejuvenation rejuvenation and skin firming. firming. The CoolLipo also uses a short pulse width that ensures maximum fat removal and that non fatty tissues are  protected. This laser liposuction technology also uses a high peak power for gentle but thorough “fat disruption”. Once the fat is disrupted and removed, the skin skin in the face and neck firms and tightens so you get the look of a facelift in an outpatient procedure, with minimal healing time in most cases.

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ProLipo - Laser Liposuction

Cosmetic surgeons using ProLipo or laser Sciton are using laser  liposuction for specific and precise contouring of the body. Like other  laser liposuction technologies, ProLipo laser liposuction uses a small laser  housed in a cannula to melt and dissolve fatty tissues that are resistant to diet and exercise. Laser liposuction is also often used in parts of the body where traditional liposuction is not available or not optimal for the best  possible results. Like other laser liposculpture, the ProLipo can be used under local anesthetic and the use of the laser typically typically reduces bleeding bleeding and bruising. By eliminating eliminating the need for  gener gen eral al anest anesthe hesi sia, a, the the co cost st of proc proced edur ures es is lo lowe were red d and th thee ri risk sk to pat patie ient ntss is substantially lowered. In some cases, Pro Lipo is performed under general anesthesia, especially if it is being used in conjunction with other cosmetic procedures, but the areas of the body treated with ProLipo will be quick to heal. The ProLipo is a laser lipolysis tech te chnol nolog ogy y th that at offe offers rs mu mult ltip iple le wave wavele leng ngth thss durin during g th thee co cour urse se of yo your ur la lase serr li lipo po  procedure. This means your cosmetic surgeon can use the correct wavelength and laser   power for each individual situation and body part being treated. The cosmetic surgeon can remove more fatty deposits or focus on tightening the skin or do these things simultaneously.

The Pro Lipo uses two wavelengths, the 1064 nm and a 1319 nm. The 1064 nm is used to disrupt and melt the fatty tissue. ProLipo has optimized their laser to effectively break up superfi supe rficia ciall vascul vascular ar fat. fat. The 1319 1319 wavele wavelengt ngth h is extrem extremely ely effect effective ive for prompt prompting ing collag col lagen en regene regenerat ration ion and skin skin tighte tightenin ning g and can be used used in conjun conjuncti ction on with with the 1064nm wavelength or each can be used separately. The object of Sciton’s ProLipo is to give the doctor maximum flexibility and  precision in patient treatment. The ProLipo is known to have excellent results in areas that are traditionally resistant to traditional liposuction including part of the thighs, the upper abdomen, the lower abdomen, the upper arms and the chin and neck. In some

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cases cas es,, co cosm smet etic ic su surg rgeon eonss ha have ve also also be been en known known to us usee Pr ProL oLip ipo o la lase serr li lipol polys ysis is in conjunction with traditional liposuction for the the best results. In other words, they may use traditional liposuction for larger areas of treatment and then follow it with ProLipo for  specific liposculpture. ProLipo has an excellent reputation as a top notch laser lipo technology. LipoLite - Laser Liposuction

LipoLite is a laser liposuction technology available to patients who are in good health and who are not using liposuction as a measure for weight loss. LipoLite laser has been used very successfully in body sculpting and contouring – and like other laser liposuction techniques is  particularly good with small areas that don’t work well for traditional liposuction and are resistant to weight loss and exercise. The LipoLite LipoLite laser liposuction liposuction te tech chni niqu quee us uses es th thee 1064 1064 nm wavelength to melt away and remove fat from beneath the skin. The tiny cannula and fiber optic laser make for minimal invasiveness during the procedure. In fact, many  physicians will use traditional liposuction techniques for the larger sites being targeted on a patient’s body and then will follow up with laser lipolysis from a technology like LipoLite. The LipoLite laser liposuction difference is in their SelectPulse™ technology. Basically, doctors can use this technology to deliver short pulses of low energy or longer   pulses of higher energy, either of which can be necessary depending on the patient and the body part being treated. This means that LipoLite LipoLite laser liposuction liposuction can treat treat areas that are fibrous or have tissue that would be traditionally resistant to laser lipo and that this technology is adept at destroying fat cell membranes for maximum results. Likee other Lik other laser laser lipol lipolysi ysiss treatm treatment ents, s, LipoLi LipoLite te is conside considered red an outpat outpatien ientt   proced procedure ure and is often often conduct conducted ed in a cosmet cosmetic ic surgeo surgeon’s n’s office office using using only only local local anesthesia. Procedures usually last between 30 and 60 minutes per body part being treated. The incision and treatment is typically very small and the recovery time is short.

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LipoLite is most often used on parts of the body like the face, neck, bra line, belly, male chest and stubborn areas of the thighs. Many surgeons will use traditional liposuction and do “the detail work” with laser lipolysis. i.

LipoThe LipoTherme rme and LipoCont LipoControl rol - Laser Laser Liposuct Liposuction ion

LipoTherme by Osyris Medical is another well regarded laser  lipolysis technology. Using a small laser housed in a cannula, fatty deposits are disrupted with heat, facilitating their removal and the look  and contour you desire. Laser lipolysis like the LipoTherme is often used in areas where traditional liposuction would not be successful and in parts of the body where diet and exercise will not be able to reduce the fatty deposit.

In the case of the LipoTherme, a 980 nm wavelength is used to target and emulsify fatty deposits below the skin. They have a specially designed and patented cannula that houses the laser and offers smooth and consistent contouring and results and a tiny incision that heals quickly and results in less scarring. LipoTh Lip oTherm ermee laser laser liposu liposucti ction on offers offers contro controll and precis precision ion to cosmetic surgeons, allowing them to target the smallest and most stubborn pockets of fat. The real difference that Osyris Medical has brought to the market is in their  LipoCo Lip oContr ntrol ol techno technolog logy, y, which which is used used in conjunct conjunction ion with with their their LipoThe LipoTherme rme laser  laser  liposuction treatment. LipoControl offers an actual on screen image of the patient’s area of treatment, beneath the skin, so the surgeon can see exactly where they are and what they are doing. The technology uses heat imaging to map the location of the laser and cannula and the laser power strengthens and weakens as the surgeon moves the cannula  beneath the skin. In fact, if the surgeon stops movement altogether, the LipoControl will turn tu rn off off th thee la lase ser. r. This This kind kind of contr control ol an and d pr prot otec ecti tion on is a gr grea eatt advan advance ce in la lase ser  r  liposuction.

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When LipoControl and LipoTherme are used together, cosmetic surgeons are able to offer the best possible results to patients. This kind of laser liposuction is perfect for  small, precise areas like the face, neck, back, parts of the abdomen and arms. In most cases, like other laser liposuction, LipoControl and LipoTherme are used in outpatient  procedures and the use of the laser technology reduces bruising and bleeding. Typically only a local anesthetic is needed, which reduces both cost and risk to the patient. Water Jet Assisted Liposuction

Water jet assisted liposuction is another method of liposuction being used by cosmetic surgeons today. As in all types types of liposuction, fatty deposits are removed from beneath the skin for a more contoured look. Liposuction is optimal for people who are in good physical shape and who aren’t interested in using liposuction as a weight loss measure. Instead of injecting the body with tumescent fluid and an d removing the fat cells manually with a cannula, or using laser technology to melt and dislodge the fat, water jet assisted liposuction actually uses a slightly pressurized stream of saline to dislodge dislodge fat and simultaneously simultaneously remove the cells. cells. Instead Instead of destroying destroying fat cells, this type of liposuction liposuction loosens the fat cells to facilitate facilitate more gentle remo removal. val. Water Jet Assist Ass isted ed liposu liposucti ction on inject injectss tumesc tumescent ent fluid fluid (salin (salinee and medici medicines nes includ including ing a local local anesthetic) into the body part being treated. Tumescent fluid is proven effective and severall alternate severa alternate liposuction liposuction technologies technologies are now using the tumescent tumescent technique technique for its local anesthetic benefits. In the case of water jet assisted liposuction, it then uses different  processes to actually remove the fat and manage fluid levels. Once the local anesthesia has taken hold, a cannula is then introduced into the tissue to irrigate and then simultaneously suction the loosened fat cell from the body. Finall Fin ally, y, any remainin remaining g fluid fluid is remove removed. d. The procedure procedure is conside considered red gentle gentle and minimally invasive and the force seen in traditional liposuction methods is not needed when using jet-assisted liposuction. liposuction. There is usually very little bruising bruising or swelling and

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water jet assisted liposuction often has a very short recovery time, partially because the use of water means that there is less tissue trauma to the body. This is another liposuction technology that does not require general anesthetic, which whi ch redu reduce cess risk riskss to the the pa pati tien entt an and d re redu duce cess co cost sts. s. Al Also so,, becau because se of th thee fl flui uid d management used in this technique, the surgeon can do a more detailed anatomical assessment while conducting the procedure, so the results are excellent. Basically, the area of the body doesn’t swell up, so the cosmetic surgeon can actually see the results of  the liposuction as he or she is doing it. Right now, one of the better known technologies in use is Body-Jet Liposuction  by Eclipse. Launched into the marketplace in 2009, water jet assisted liposuction is quickly gaining popularity. These new technologies that offer a gentler and more precise approach are quickly adopted because of their effectiveness and the quick healing time.

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FACTORS

Important factors that affect the success of abdominal liposuction include : the amount and location of abdominal fat, history of weight gain and weight loss, history of    pregnancy,

the

age

and

the

sex

of

the

patient.

Criteria

Explanations

Previous Previ ous Pregnancy Pregnancy

A previous previous pregnancy pregnancy tends tends to stretch stretch the the abdominal abdominal muscles, muscles, and cause cause the lower  lower  abdomen to bulge to a certain degree. This curvature of the abdominal wall muscles determines the flatness or the shape of the abdominal silhouette after  lipos liposuct uctio ion. n. Neve Nevert rthe hele less ss,, th thee va vast st majo majori rity ty of wome women n who ha have ve be been en  pregnant are ultimately very happy with results obtained by liposuction alone, and do not require an abdominoplasty (tummy tuck).

C-Se C-Sect ctio ion n Bul Bulge ge

The The Pf Pfan anne nens nsti tiel el incis incisio ion n is the the na name me for the the in inci cisi sion on acros acrosss th thee lo lowe werr ab abdo dome men n that is typically made for Cesarian sections, or a hysterectomy. A common  but undesirable consequence of a Pfannenstiel incision is a persistent bulge of  subcutaneous fat just above the incision. Liposuction can easily repair this annoying deformity.

Pr Prio iorr obes obesiity

Pr Priior obe obesi sitty and and subs subseq eque uent nt wei weigh ghtt loss loss pr produc oducee fat fat that that is is more more fib fibrrous. ous. Thi Thiss makes liposuction more difficult.

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Criteria

Location

Explanations

Locati ation on of abdo abdomin minal al fat is an import important ant factor factor in predic predictin ting g the success success of  of   Loc

Abdominal

ab abdo domi minal nal lipos liposuc ucti tion. on. Abdo Abdomi mina nall fa fatt oc occur curss in tw two o di diff ffer eren entt le leve vels ls::

Fat

superficial and deep. Superficial abdominal fat is located just below the skin and above the abdominal muscles. The deep abdominal fat is located inside the the abdom abdomin inal al ca cavi vity ty on th thee in inte test stin ines es.. Some Some pe peopl oplee ha have ve mo more re de deep ep (intestinal) fat than subcutaneous fat. Subcutaneous fat can be removed by liposuction. Intestinal fat cannot be removed by liposuction because it would  be too dangerous. Fat on the intestines can only be diminished by weight loss thro throug ugh h diet diet an and d ex exer erci cise se.. Th Thus us li lipos posuct uctio ion n ca cann nnot ot re remo move ve al alll of th thee abdominal abdomi nal fat. Most patients patients have more subcutaneous subcutaneous fat than intestinal intestinal fat. Thus, most patients will see a good cosmetic improvement with abdominal liposuction.

Age

Age of the patient is not an important factor in the success of liposuction. Some of   the happiest patients are women who are more than 60 of age. In a healthy older woman, liposuction can improve an obese abdomen with little risk or  discomfort.

18

 

Fema Female le Pati Patien ents ts

Fe Fema male le pati patien ents ts hav havee soft softer er and and les lesss fibr fibrous ous fa fatt than than men, men, and and the there refo fore re lip lipos osuct uctio ion n on a woman is easier to perform.

Successful Liposuction This is defined and determined by the degree of a patient's happiness with the results. Ultimately the patient's opinion of the cosmetic results depends on multiple factors, including : the patient's expectations the patient's preoperative cosmetic deficiencies the surgeon's technical skills and technique. The results are never completely predictable. COMPLICATIONS

A surgical complication is defined as any undesirable result of surgery. The most common complication of liposuction is a result that produces an unhappy patient. The most common cause of an unhappy patient is a patient's unrealistic expectations before surgery. Avoiding unrealistic expectations requires careful and accurate communication  between patient and surgeon. Detailed information about specific complications is : Complication

Explanation

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1. Excessive Liposuction

The greatest rriisks of of lliiposuction ar are as associated wi with th the ten tend dency of  of  some surgeons to do too much surgery on the same day. The three types of excessive surgery include : •

removal of an excessive volume of fat by liposuction on a single day

•

liposuction of an excessive number of body areas on the same day

•

combi com bina nati tion onss of li lipos posuct uctio ion n an and d ot othe herr un unre rela late ted d su surg rgic ical al   proc procedu edure ress which which in invo volv lves es ex exce cess ssiv ivee su surg rgic ical al tr traum aumaa and  prolonged exposure to general anesthesia.

1. Common

&

Minor   Common & minor complications are conditions that do not threaten

Complications

a patient's life, normal body functions or the ability to work. These include superficial irregularities of the skin, seromas, hematomas, focal skin necrosis, allergic reactions to drugs, visible or disfiguring scars, sca rs, discol discolora oratio tion n of the skin, skin, fainti fainting ng during during or after after surger surgery, y, tempor tem porary ary bruisi bruising, ng, numbne numbness ss or nerve nerve injury injury,, and tempor temporary ary ad adve vers rsee drug drug re reac acti tion ons. s. Most Most of th thes esee co comp mpli lica cati tion onss ca can n be considered minor, however some may become quite serious. Postliposuction syncope (fainting) the next morning at home, especially after urinating is not rare. This can be serious if the patient falls and experiences a head or neck injury.

2. Rare Rare & Seve Severe re Com Compl plic icat atio ions ns

as asso soci ciat ated ed wit with h liposu liposuct ctio ion n in incl clud udee pr probl oblem emss with with anesth anesthes esia ia,, bl blood ood clots in the leg or lung, injury to the abdominal organs, excessive intravenous fluids, excessive blood loss, excessive loss of body heat (hyp (hypot other hermi mia) a),,

infe infect ctio ions ns,,

al alle lerg rgic ic

dr drug ug

re reac acti tion ons, s,

as aspi pira rati tion on

 pneumonia (most likely under general anesthesia), cardiac arrest and  potentially fatal cardiac arrhythmias, permanent nerve damage, brain da dama mage ge du duee to la lack ck of oxyge oxygen n under under ge gener neral al an anes esth thes esia ia,, an and d seizures. 3. Drug Drugss That That Incr Increa ease se Blee Bleedi ding ng

Drug Drugss that that incr increa ease se bl blee eedi ding ng,, if ta take ken n by a pa pati tien entt soon soon be befo fore re

20

 

having hav ing liposu liposucti ction, on, can cause cause liposu liposucti ction on com compli plicat cation ionss such such a hematoma hemat oma (a large collection collection of blood trapped beneath the skin) skin),, or  excessive excess ive bleeding bleeding that might require require hospitalizat hospitalization. ion. Among the more common drugs that can interfere with normal clotting of blood are aspirin, aspirin, ibuprofen ibuprofen (Motrin, Advil), and warfarin warfarin (Coumadin). (Coumadin). Even vitamin E, red wine, and some herbal remedies can cause   pro prolo long nged ed blee bleedi ding ng.. Pa Pati tien entt ar aree pr prov ovid ided ed wi with th a lo long ng li list st of    prescript prescription ion drugs and non-prescri non-prescription ption drugs that interfere interfere with 4. Risk Riskss of Lo Loca call Anes Anesth thes esia ia

 bleeding. Lido Lidoca cain inee is the the safe safest st of loc local al ane anest sthe heti tics cs ava avail ilab able le for for li lipo posu suct ctio ion. n. At

lidocaine

concentrations

in

the

blood

exceeding

6

milligram mill igrams/lit s/liter, er, patients patients might experience experience some toxicity. toxicity. Blood concent con centrat ration ionss of lidocai lidocaine ne in excess excess of 12 milli milligra grams/ ms/lit liter er can   produc producee seriou seriouss cardia cardiacc toxici toxicity ty.. The maxim maximum um recomm recommende ended d dosage dos age of lidoca lidocaine ine for tumesc tumescent ent liposu liposucti ction on is 50 mg/kg mg/kg (50 milli milligram grams/k s/kil ilogr ogram am of patien patientt weight weight). ). The most most extrao extraordi rdinar nary y aspect of the tumescent technique is its unprecedented safety record when used as directed. Most liposuction surgeons know that it can  be dangerous to give a patient a dosage of tumescent lidocaine that ex exce ceed edss 50 mg/k mg/kg. g. Al Alll li lipo posu suct ctio ion-r n-rel elat ated ed death deathss ha have ve be been en associated with either the use of general anesthesia, or IV sedation, or lidocaine doses in far in excess of 75 mg/kg. The tumescent technique is dangerous in the hands of surgeons or anesthesiologists who have not had specific training in the technique. There has never   been a reported reported death associated associated with tumescent liposuction liposuction totally totally 5. Ri Risk skss of of Gen Gener eral al Anes Anesth thes esia ia

 by local anesthesia. Gene Genera rall ane anest sthe hesi siaa ffor or li lipos posuct uctio ion n can can be be ccon onsi side dere red d saf safee when when : •

the the ge gener neral al an anes esth thes esia ia is ad admi mini nist ster ered ed by a bo boar ard d ce cert rtif ifie ied d anesthesiologist,

•

lipo liposu suct ctio ion n is not pe perf rfor orme med d wi with th ot othe herr unrel unrelat ated ed su surg rgic ical al  procedures

•

there is no excessive liposuction. 21

 

The most dangerous aspects of general anesthesia are respiratory depression and impairment of protective airway reflexes. The risks of general general anesthesia anesthesia include human error, unsuspected unsuspected inherited inherited hy hype pers rsens ensit itiv ivit ity y

to an anes esth thet etic ic dr drugs ugs,,

ac acci cide dent ntal al ov over erdo dose se of 

anesthesia, any undetected airway disconnection or airway blockage. General anesthesia, which increases the risk of vomiting and impairs  protective airway reflexes, can cause aspiration of stomach contents. Because general anesthesia impairs the ability to breathe, when a 6. Dangers

complication does occur it can lead to disaster. Ultrasonic Ultr Ultras ason onic ic Assi Assist sted ed Li Lipo posu suct ctio ion n (UAL (UAL)) re requ quir ires es th thee use use of 

of

Liposuction

tumescent fluid and uses either a metal probe or metal paddle to deliver ultrasonic energy and heat into subcutaneous fat. Internal UAL UA L ha hass la larg rgel ely y be been en aband abandone oned d be beca caus usee of th thee ri risk sk of fu full ll-thic thickn knes esss sk skin in bu burn rnss an and d seve severe re sc scar arin ing. g. The The in init itia iall re repo port rtss of  internal UAL were unrealistically enthusiastic. Some authors did not report their complications, and others have learned of major UAL complications after publishing their articles. Because of insufficient  proof of safety, UAL devices have not been approved by the FDA for use in doing liposuction.

SAFETY

Safety is a Relative Term It is impossible to prove that a surgical procedure is absolutely safe. On the other  hand it is realistic and appropriate to compare two procedures and conclude that one is relatively safer than the other. Prospective liposuction patients should strive to understand the

options

that

are

available

and

choose

the

safest

procedure.

Preventing Complications Preventing Preve nting complications complications should be the most important important concern of both patients and liposu liposucti ction on surgeon surgeons. s. Surgeon Surgeonss can reduce reduce the ris risk k of com compli plicat cation ionss by pro proper  per  selection of patients. Surgeons should avoid patients who have •

unrealistic medical expectations

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•

a history of significant medical problems.

Patients can reduce the risk of complications by •

resisting the temptation to save time by attempting to do multiple unrelated surgical procedures along with liposuction

•

resisting the temptation to maximize the volume of fat removed on a single day. It is much safer to divide one very large liposuction procedure into two or more separate  procedures  proced ures done on separate days. Liposuctio Liposuction n by general anesthesia anesthesia can be considered considered safe, however, liposuction totally by local anesthesia is safer.

TREATMENT

Is liposuction a treatment for weight loss? Liposuction is a procedure for shaping the body and is not recommended for weight loss. It is a surgical procedure in which fat is removed from under the skin

with the use of a vacuum-suction cannula (a hollow pen-like instrument) or using an ultrasonic probe that breaks up the fat into small pieces and then removes it with suction. Persons with localized fat may decide to have liposuction to remove fat from that area. It doesn’t guarantee permanent weight loss. To avoid weight gain after  liposuction, people need to eat right and be physically active. Complications from liposuction may include infection, embolism (fat gets trapped in the blood vessels,

23

 

gathers in the lungs, or travels to the brain), puncturing of organs, seroma, pain or  numbness, swelling, burns, skin problems, and reactions to the anesthesia.

24

 

FAQ ABOUT LIPOSUCTION :

Who

is

a

good

candidate

for

liposuction?

A good candidate for liposuction is defined as any patient who is likely to be happy with the results of liposuction. The best candidates for liposuction are in good health and have realistic expectations of what liposuction can accomplish and can  provide a good candidate with a significant improvement, but it is unlikely to achieve perfection. There is no definite age or weight limit for patients who are "good candidates" for liposuction. Many liposuction patients are of average size but are concerned about localized accumulations of fat. However, some of the happiest  patients have been individuals who are somewhat obese. A good candidate usually has one or more localized accumulations of fat that can be removed by liposuction. Who is not a good candidate for liposuction? A person who expects absolute perfection is not a good candidate for liposuction. Excessively obese patients are usually not good candidates c andidates for liposuction. A person who has a serious medical problem is not a good candidate for liposuction.

25

 

Is

liposuction

a

reasonable

treatment

for

obesity?

Liposuction is not a good treatment of obesity. Liposuction is not effective, even as a last resort, for people who are unable to lose weight by dieting and exercise. Obese patients almost always regain the weight that is removed by liposuction unless there is a dramatic reduction in calorie intake (by dieting) or a significant increase in calorie expenditure (by exercising). Whenever large-volume liposuction has been used in an attempt to treat obesity by surgery, there has been a significant increase in the incidence of serious surgical complications. It is not safe to remove huge amounts of fat by liposuction. It is dangerous to remove more than 8 to 10  pounds of fat by liposuction in a single day. Thus, liposuction will not be of any significant benefit for an obese patient who believes that liposuction will aid in the effort

to

lose

weight.

On the other hand, an overweight person whose weight has been stable for many years and has certain problem-areas of fat may be a good candidate for liposuction. Li Lipo posu suct ctio ion n in an ob obes esee patie patient nt is re reas ason onab able le when when th thee go goal al is to im impr prov ovee a troublesome body contour area. It is not reasonable to use liposuction as a surgical technique for weight loss.

26

 

REFERENS

1. http://www.liposuction.com 2. http://www.copacabanarunners.net/i-liposuction.html 3. http://www.weight-loss-surgery-info.com/liposuction.html 4. http://www.tip2000.com/health/liposuction.asp 5. http://www.usnews.com/health/family-health/articles/2008/08/19/weightmanagement.html 6. http://www.copacabanarunners.net/i-liposuction.html 7. http://ezi http://ezinearti nearticles. cles.com/?T com/?The-Myt he-Myth-Ofh-Of-Lipos Liposuctio uction-For n-For-Weig -Weight-Lo ht-Loss ss

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