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New York Plastic Surgery - Robert A. Guida, MD, FACS

Liposuction - Tumescent Technique

The Procedure:
Looking and feeling good means having a fit, well-proportioned body. For many people, this may seem like an unreachable goal. Often, even a strict diet or a disciplined exercise program can't remove stubborn areas of excess fat. For those who seek a smoother or better proportioned body contour, liposuction may be the answer.

Liposuction is a surgical procedure that removes deposits of excess fat from specific areas of the body, face or neck. Liposuction can be used to slim the hips and thighs, flatten the abdomen, shape the calves and ankles or eliminate a double chin.

You'll find basic information here about liposuction. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with Dr. Guida.

Best Candidates:
The best candidates for liposuction are men and women who have realistic expectations, are in generally good medical condition, and are likely to be happy with the results of liposuction. The best results are seen in patients of relatively normal weight who simply want to improve their body contour.

The procedure can produce excellent results for people who have deposits of excess fat that make certain body areas appear disproportionately large. Although liposuction is not a treatment for obesity, it can permanently alter body proportion and is sometimes the only way to eliminate fat deposits that do not respond to diet and exercise.

People of almost any age may undergo liposuction; however, patients with good skin elasticity will achieve the smoothest contour after fat is removed. You may be a good candidate for liposuction if you desire fat removal or contouring in any of the following areas:
  • Cheek, chin and neck
  • Abdomen and waist
  • Inner and Outer Thighs
  • Hips and buttocks
  • Back
  • Upper arms
  • Breast or chest area
  • Inner knee
  • Calves and ankles

Liposuction can be performed on several areas of the body at the same time or done in conjunction with other cosmetic surgery procedures, as long as you understand that there is increased risk and your surgeon feels that having multiple procedures is a safe option for you.

Liposuction is an excellent way to treat some cases of gynecomastia, or male breast enlargement, which occurs in both teenagers and adult men.

Liposuction cannot serve as a substitute for dieting and exercise. Nor is it an effective way to treat cellulite (a condition that gives the skin a dimpled appearance).

Also, certain medical conditions may complicate liposuction. They include: diabetes, high blood pressure or heart disease and previous surgery near the area to be contoured. It's important to let Dr. Guida know if you have any of these medical conditions or if you have had surgery in the past


What can I expect from the consultation?
A personal consultation with Dr. Guida is the first step for every patient considering liposuction. During this meeting, he will assess your general physical health and discuss your specific cosmetic goals for the procedure.

Depending on the parts of your body that you would like to have treated with liposuction, you may be asked to undress. Dr. Guida will fully assess the extent of correction needed. You will also be asked to point out the exact areas where you would like to see improvement. Digital images will be taken and reviewed with Dr. Guida on a computer to assess the problem areas objectively. Often times, digital imaging can be done to morph or alter the digital picture so you can see what sort of improvements you could expect from liposuction.

You should arrive at the consultation ready to provide complete information about:

  • Previous surgical procedures.
  • Past and present medical conditions.
  • Medications you are taking, including herbal remedies or nutritional supplements.

How is liposuction performed?
Dr. Guida exclusively uses the tumescent technique for liposuction using smaller diameter cannulas. Tumescent liposuction refers to a technique that uses large volumes of very dilute local anesthesia that is injected into the fat causing the targeted areas to be come swollen and firm. This makes removal of the fat more precise and easier. Additionally, the local anesthesia persists for many hours after the procedure so there is rarely a need for narcotic pain medication after surgery.

To perform liposuction, one or more small incisions are made near the area to be suctioned. Whenever possible, incisions are placed within the natural folds or contour lines of the skin so that they are inconspicuous. Dr. Guida then places a slim, hollow tube called a cannula through the incision so that its tip penetrates the underlying fat. After the cannula is connected by flexible tubing to a suction pump, Dr. Guida moves the cannula back and forth through the fat, which is vacuumed into the tube.

How may I learn more about the safety of liposuction?
Each year thousands of people undergo liposuction and experience no major complication. However, you must fully understand the risks as well as the procedure. One of the most important parts of your consultation with Dr. Guida is reviewing the possible complications of liposuction. In addition to listening carefully to what Dr. Guida tells you, be sure to raise any questions or concerns that you may have.

Liposuction is one of the most commonly performed cosmetic procedures performed and is extremely safe, when done properly. Dr. Guida and his staff are dedicated to your safety and obtaining the best surgical result for you.

What can I do to prepare for my surgery?
When the date for your surgery has been set, Dr. Guida will provide you with specific instructions for the days immediately before and after your surgery. A number of points may be covered, including:

  • Avoiding certain medication that may complicate surgery or recovery.
  • Stopping smoking for two weeks before and after surgery.
  • Arranging for help or special care following surgery.

How will I be cared for on the day of my surgery?
Liposuction is usually performed in our office based surgical suite. Dr. Guida will select the type of anesthesia that provides the safest and most effective level of comfort for your procedure. For some patients, local tumescent anesthesia alone is used, with no intravenous sedation, which numbs only the affected areas. For others, tumescent anesthesia with a small amount of intravenous sedation administered by a board certified anesthesiologist may be used. The best form of anesthesia for you will be chosen based on Dr. Guida's evaluation in conjunction with your personal preference.

Regardless of the type of anesthesia used, your physical status will be closely monitored throughout the procedure and during your recovery.

How will I look and feel after liposuction?
When the procedure is complete, you will be taken to a recovery area. Because the tumescent anesthetic works for many hours after the procedure, frequently there is no pain after the liposuction. Any discomfort you may feel can be controlled with medication prescribed by Dr. Guida.

A specially designed compression garment may have been applied over the treated areas to control swelling and assist healing. Dr. Guida will tell you how long you must wear the garment and how you can remove it to bathe.

In general, you will be encouraged to get out of bed the evening of surgery or certainly by the next day. In order to prevent the risks of blood clot formation in the legs or lungs, Dr. Guida strongly recommends immediate walking shortly after surgery the procedure.

Most people can return to light activity and a desk job within a few days after surgery. Light exercise can be done within a week after surgery. If there is soreness, the amount of exercise should be limited.

What should I know about my liposuction results?
Quite soon after surgery you will see a noticeable difference in the shape of your body. However, improvement will become even more apparent over a period of 2 to 3 months, when fluid retention and swelling have subsided.

After your liposuction surgery, you may notice that clothes fit more comfortably and you feel more confident about your appearance. As long as you do not gain a significant amount of weight, your new, slimmer contour will be permanent. Many patients who gain a few pounds after surgery find that the weight distributes itself more evenly and does not settle in the same "problem areas."

How long will I continue to see Dr. Guida after my liposuction?
After the initial healing period of about 1 week, you will return to Dr. Guida's office for a postoperative follow-up visit so that your progress can be evaluated. In the following months he may ask you to return for periodic checkups. It's important to keep these appointments so that Dr. Guida can assess your long-term results and address any questions or concerns you may have.

 

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