Liposuction (Liposculpture or Lipoplasty) in San Diego
Liposuction is a very common, popular procedure. It is designed for the permanent removal of fatty tissue. It is an elective procedure that allows the cosmetic surgeon to remove undesirable, subcutaneous fat in isolated areas that do not respond to diet and exercise. These areas may include the hips, buttocks, flanks, thighs, arms, abdomen, knees, ankles, face and neck (among others).
Liposuction is most successful in people with good skin tone who have fatty deposits. It is not a treatment for obesity. If weight gain occurs following liposuction, the fat will be tend to be deposited in areas that have not been treated. The procedure can be repeated, if necessary. To maintain the safety of the procedure, there is a limit on how much can be done at one time.
A variety of factors can affect the results: Physical condition, genetic makeup, diet, exercise, smoking, alcohol intake, skin elasticity, and age.
Body contours made irregular by fat can be improved by this procedure; it cannot correct contours that are irregular for other reasons, such as muscle weakness or hernia. However, combined with other procedures, liposuction may correct these other deformities with good results.
There are new techniques available to harvest Adult Stem Cells at the time of your liposuction. These can be banked for a patient's potential therapeutic use in future years. Please discuss this option with your doctor if it is of interest to you.
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Liposuction is done under general anesthesia on an outpatient basis in a hospital or surgical center. The surgeon makes small (less than 1/2 inch), discrete incisions in the areas to be treated. A cannula is inserted in a small incision and attached to a suction machine. The procedure may take 1-4 hours, depending on how many areas are treated. Drain tubes may be used
Recovery from liposuction is normally relatively easy. Expect a fair amount of swelling and bruising in the following weeks. You will wear special garments, provided to apply pressure, minimize swelling and provide support while healing. These garments also assist in retraction of the skin. Stitches will be removed in a week to 10 days.
Results are recognizable almost immediately and will continue to improve as swelling subsides. The day of or the day after surgery you should be up and walking around. Increase your activity daily until full activity is resumed as instructed. Avoid the sun until all bruising has subsided. A sunscreen should be used routinely; it is easy to get sunburned during recovery because of decreased sensation.
The results of liposuction are not permanent. If you were to gain a large amount of weight, you might note rippling in the treated areas, depending on your skin elasticity.
Following liposuction, the scars will go through a maturation process-during the first 8-12 weeks they may be red and possibly raised. The scars will mature over 6-12 months and become pale, flat and soft. You may experience numbness, burning, and tingling around the incision site. These symptoms are almost always temporary.
Please let us know if you are prone to keloid scars.
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Liposuction Post-Op Information
1. After surgery, you will be placed in a postop surgical garment. This will be padded with foam pads, in order to give uniform pressure. The garments help the swelling go down faster and encourage better, smoother healing.
Please do not remove this garment until we so instruct you. If drains are in place, you will be asked to call our office each weekday morning and tell us your drainage totals. We remove drains based on the color and amount of drainage over the past 24 hours. It is very difficult to pull the drain out accidentally. It may be slightly uncomfortable, and, if you are experiencing pain, let us know. Hopefully, we can relieve your pain with just a phone call.
It is common to have some oozing around the drain site, of a light pinkish or reddish color. If there is more than a small amount of oozing, please call us during office hours to report this.
The drains are in place so that your body does not have to absorb as much fluid that might otherwise collect under the skin. They reduce the risk of wound-healing problems and reduce bruising.
2. After your drain is removed, you may shower. We will give you instructions regarding wound care. After showering, you should leave the Steri-Strips in place, which may have been placed over the small incisions in your liposuction areas.
After you take off your girdle, we will either give you a replacement garment or girdle, or you may use bike shorts or Capri-length exercise garments. We will speak with you regarding this at the time we change your dressings or pull your drains. You will be asked to wear some form of a compression garment for a period of weeks after surgery. Four weeks is the minimum.
You will be prescribed postoperative pain medication, to be used for the first several days after surgery. Please be aware that the common side effects of any narcotic pain medication are nausea, vomiting, constipation, and itching. Should these occur, stop the pain medication and take Tylenol. You may want to try alternating the narcotic pain medication with plain Tylenol. A stool softener or laxative can be helpful for constipation, should this occur. Take whatever you have taken in the past, or consult your pharmacist. Milk of magnesia has worked well as an over-the-counter product.
You may expect bruising and swelling for a period of weeks after surgery. Gravity usually causes the swelling to migrate down towards your legs. Sometimes even the feet and ankles may swell, for the first several weeks. It is common to have swelling in the suprapubic region and in the perineum.
3. There may be firm areas and some indentations in the skin for the first few weeks after surgery. This will slowly improve with time. Most patients look fairly good at about six weeks. However, your final result, as far as the amount of postop swelling that you have, will not be visible until you are 6-12 months out from the surgery. The firm areas may persist off and on for several weeks, or even months. Massaging the areas can sometimes help decrease the firmness.
We have two massage therapists on staff. Should you so desire, they can help with lymphatic drainage and more rapidly improve the amount of swelling and unevenness in your skin. He or she is available for postoperative lymphatic massage. However, you need to speak with us before scheduling, to make sure that this is an option, in your case.
The skin may be numb to the touch for the first few weeks after surgery. This may even persist for several more months. As the sensation returns, you may feel slight pains. This will usually improve with time and can be improved by massaging the skin with skin lotion or using a washcloth to rub lightly over the skin. This will help to desensitize the area. Once again, a massage therapist can lessen the sensation.
You may have some drainage from the incisions for the first few days, even up to a few weeks, after surgery. This will slowly diminish.
4. We will be teaching you how to do some scar massage with Mederma, which is an over-the-counter herbal scar cream. It is not mandatory, but, if you choose not to purchase this, you may use any lotion or cream that you feel will not be irritating to your skin. We will have you do this 4-5 times per day, for a minute or two each time, for a total of 10 minutes per day. It starts at two weeks after surgery and is continued for 2-3 months after surgery. We will be giving you, once again, specific instructions regarding this.
5. There should be no strenuous activity, such as jogging, aerobics, golf, tennis, or bike riding, etc., for four weeks after surgery. You may walk after surgery for short distances. You may drive a car, as long as you are not medicated. Driving, as long as you are comfortable, may begin as soon as 4-5 days out from surgery. Your recovery time will depend on the areas that are liposuctioned and the amount that is removed. If you have specific questions regarding your activity, please question our staff. We would be happy to give you the specifics of your case, according to the amount and type of exercise and activity. When you return to full exercise, you may have a small amount of swelling return. However, this is temporary, until your body is able to resorb the swelling that has accumulated.
6. The fat cells that are removed are gone forever. However, it is still possible to gain weight. You must maintain a reasonable diet and exercise routine, so that the weight will not come back. We have a nutritionist on staff. If you have concerns regarding diet and balance of intake, you may question her. She has a background in dietetics and can certainly help diagnose and treat any eating issues that you may have.
7. A common concern after liposuction is that, if the fat is removed in one area, it may be more apparent in the areas that have not been treated. You should not see any significant changes in other areas. We have photographs taken of you preoperatively, which you can use to measure your progress. Please be assured that as much fat as can be safely taken out will be removed at the time of your liposuction.
8. Your clothes will probably fit differently early on after the surgery, because of the swelling and the surgical garments, etc. It can take several weeks to several months for the swelling to go down enough to make a difference in clothing size. Some patients may not see a change in the clothing size, but the clothes they have may fit better. This all depends on the configuration of the fat prior to surgery and how you wear your clothing.
9. Please feel free to call us, should you have any concerns or worries after surgery. It is always best to call during office hours, as there is always someone in the office who can see you and your chart is available. We cannot make a diagnosis over the phone. Should your complaints suggest a need, you may be asked to go to the emergency room, if the office is closed. This can be very inconvenient, as well as expensive. Insurance companies will usually not pay for an emergency room visit related to cosmetic surgery. Therefore, always try to call us during office hours, when possible.
10. Should something be bothering you in the morning, please do not wait until the evening to call. It would be much better for us to see you during the day. If you call after hours and need to speak to the person through the exchange, and if you have not called during the day, especially in matters requesting pain medication, the person who is on call may not be able to help you, as they will not have a chart or medication record in front of them.
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