Liposuction, Ultrasonic Liposuction, Electrolipolysis at Plastic Surgery Truth.com

is used to improve the body’s contours, a technique used on its own or in conjunction with other procedures. It has been practiced since the late 60s, and with more than 400 000 treatments a year, it is one of the most popular cosmetic procedures. Liposuction is an operation, which is why it should only be performed by an experienced surgeon. The technical skill and aesthetic judgement required are considerable. Patients eligible for liposuction should not be overly obese, as no more than three litres of fat (in total around six litres of fluid) can be removed. Also, the patient’s connective tissue needs to be fairly flexible. Patients should have tried out weight loss approaches such as dieting and sports previously – with the conclusion that their problematic areas remain unaffected by low-calorie food and fitness training.

Techniques
Tumescent technique (lat. Tumescere = to swell): This is the most commonly used method. Tiny incisions are made in the skin on top of the fatty tissue, and approx. Three litres of saline solution are pumped into the tissue through these holes. The fat cells absorb the liquid and swell up, which makes it easier to dislodge them. The saline solution contains a local anaesthetic, as well as adrenalin to minimise blood loss. Already during the one-hour soaking stage, the fat cells begin to detach from the connective tissue, nerves, blood vessels and lymphatic vessels surrounding them.

liposuction cannula

The surgeon removes the loosened fat cells using a thin suction cannula, covering the tissue in a rapid, powerful wiping motion. With his other hand, he controls the suction. The procedure can last up to three hours and requires substantial physical stamina on the part of the surgeon. In large-scale operations, a general anaesthetic is used.

Power-assisted liposuction (lipolysis by vibration): This is an enhanced variation of the tumescent technique, in large parts developed by Dr. Gerhard Sattler german surgeon. An electrically powered cannula containing 24 suction holes, the “Sattler cannula”, is used to agitate the fat cells up to 4000 times per minute and literally shake them out of the connective tissue. With this method, it is impossible to damage any blood vessels or nerves, and difficult areas containing a large amount of connective tissue (e. g. calves or ankles) can also be lifted and contoured. Another advantage of this technique is that the patient only needs a local anaesthetic; together with the surgeon, he or she can control the cannula’s suction path.

liposuction plastic surgery Ultrasonic Liposuction (also known as “Ultrasound-Assisted Lipoplasty” or UAL): This method complements the tumescent technique, employing special cannulas that project ultrasound waves into the fatty tissue. This sonic treatment explodes and liquefies the fat cells without damaging the connective tissue. UAL is used predominantly for areas with a significant amount of connective tissue, e. g. the male breast or the upper back, but also for follow-up operations. The technique is more elaborate, requires a longer period of sedation and contains the risk of burning the skin or subcutaneous tissue.

Electrolipolysis: This technique is normally employed in conjunction with a hormone therapy for treating cellulite. The practitioner inserts a fine acupuncture needle into the fatty tissue and induces an electrical current. The fat cells become porous and the fatty acids drain out. The procedure usually takes no longer than an hour. After 8-12 sessions, the orange-peel skin on the thighs should be gone.

Liposuction offers varying degrees of success for different problem areas:

- Suction works well on fat deposits on the

hips and upper thighs (also known as “saddlebegs”)

waist

inner knees,

- less well on the

tummy (after the operation, the patient should sit upright as little as possible as permanent folds may appear in the tissue)

neck, back of the neck

double chin, nasolabial folds (the tissue can be reduced by up to ten percent without the risk of later creasing)

cheeks

- with partial success on the

back

inner things

buttock folds (sitting down should be avoided in the weeks after the operation as much as possible, as there is a possibility that the skin around the fold will bulge inwards; if too much fatty tissue is removed, the buttocks may soon sag again)

ankles (the flow of lymphatic fluids and venous blood may be impaired for several months and the ankle may swell up considerably; haematomas may result in skin discolouration)

- and with little success on the

back and front of the upper thighs

calves

lower arms

Once fatty tissue is removed, it is eliminated permanently – at least from the areas treated. Unfortunately, weight may still be gained in other parts of the body. If liposuction was performed on the upper thighs, for example, new fat pads may form on the hip or the lower abdomen. Some surgeons don’t remove all the fatty tissue in one session but choose to remove only e. g. 70 percent; in subsequent sessions, they again remove 70 percent (of the remaining 30 percent) and continue in this manner until the desired result is achieved. This spread-out approach gives the surgeon greater aesthetic control over contouring the body.

Before the operation:
- The surgeon outlines and shades the skin areas to be treated with coloured marker pens.
- Depending on the extent of the operation, general or local anaesthesia is administered.

After the operation:
- Immediately after the procedure and for the following six weeks, the patient needs to wear elastic support garments. These are essential for relieving swellings and haematomas and help the skin adjust to the new contours.

- 7-10 days after the operation, the stitches are removed. - At the earliest, the new body contours become visible six weeks after the operation. - The patient is ready for work or social life after one week.

Risks:

- Pronounced swelling which may persist for three to six months or longer, particularly on the face or ankles - Small scars (these are soon indistinguishable from normal skin) - Stinging or numbness of the skin in the wound area – may last for a week or up to two months - Intense pain, especially where fatty tissue is located next to muscle tissue (e. g. back, upper hip, waist) - Sensory nerve damage - An asymmetrical body outline, bumps or dents in the skin surface; surgical corrections may be performed after six months