What is liposuction?

Liposuction is the process of removing localized fat by means of a cannula connected to a vacuum system (aspirator). Liposuction slims and reshapes specific areas of the body by removing excess fat deposits and improving body contour and proportions.

What can liposuction treat?

Thighs. The characteristic of this anatomical area is that it has a thin skin, without muscular insertions, so that when there is a significant decrease in volume, it is very easy for the skin to appear flaccid. Therefore, this area must be treated with great caution.

Cartocks. The trochanter or cartridge area has some particularities that make it a good candidate for liposuction, as the skin usually retains a good elasticity until an advanced age. In addition, the area allows easy adaptation of compression garments or girdles, which means that a correct postoperative period offers better results than in other locations, and it is an area with little pain, which allows the patient to quickly return to normal life.

Abdomen and waist. Abdominal liposuction is a widely demanded surgery. It tends to be a common area in both sexes, but for different reasons, in men, obesity with a dietary cause predominates. In women it is common to see accumulations after childbirth (not to be confused with flaccidity or diastasis recti).

Upper arms. The “bat wings” as some patients refer to this deformity, can be mitigated with a very simple liposuction. However, if there is significant skin flaccidity, the most sensible thing to do is to recommend an arm lift or brachioplasty to the patient.

Back. The back has an extremely thick dermis, therefore any surgical procedure we perform on the area will adapt correctly. The most frequent area where we can discover real accumulations of fat is the area above the waist, between the waist and the shoulder blades.

Knee. It is an easy area to liposuction. This area is excellent in that the skin will adapt without any problem to its new volume, leaving no flaccidity whatsoever.

Lateral area of the back or “tail” of the breast. In the lateral area of the back, in the upper area, is the birth of the breasts. This area, in patients with gigantomastia or a certain degree of obesity, often has a bulge that makes it appear as if the breast is growing out of the back. Therefore, it is a liposuction of almost mandatory use in reduction mammoplasties, and in general liposuction of body contouring.

Mammary glands and thorax (in men). Gynecomastia is a benign and frequent pathology, but quite disabling. There are many causes that can produce it, drugs such as cimetidine, use of anabolic steroids, etc. It can also be secondary to hormone-secreting tumors, rare chromosomal syndromes with stages of intersexuality… Finally, it can be produced by an involution of the hormone purifying and transforming mechanisms, a well-known phenomenon that affects males in old age and is known as senescence gynecomastia. Sometimes liposuction by itself is the treatment for this pathology, however in many occasions it is necessary to combine it with a gland removal.

Jowls. Practically all people from a certain age, and some from very early stages, present an increase in the volume of adipose tissue in the jowl area, which can become so important that the neck/mental angle ends up being replaced by a straight line. If the problem is that the structures of the floor of the mouth have sagged or that excess skin has accumulated due to flaccidity in upper areas, the correct recommendation will be a cervical facelift, since liposuction will only worsen the symptoms. If, on the other hand, we find a real accumulation of fat, liposuction will be the technique of choice. In the case of liposuction, it can be performed under local anesthesia and/or sedation.

Calves and ankles. In some patients we find that this definition of shapes does not exist, and fatty deposits appear in the ankle area and below the knees, just in the area where the leg should be slimmed down. It is what we call “elephant’s foot” because it is straight and of the same thickness along its entire length. Liposuction in this area is effective and can be performed under local anesthesia and/or sedation.

In general, liposuction can be performed alone or in conjunction with other plastic surgery procedures, such as a facelift, breast reduction, abdominoplasty, etc.

Liposuction is neither a treatment for obesity nor a substitute for proper diet and exercise. It is also not an effective treatment for cellulite (the dimpled skin that usually appears on the thighs, hips and buttocks) or sagging skin.

Liposuction procedure

– Anesthesia. Options include local anesthesia, intravenous sedation and general anesthesia, depending on the case, the extent, the areas to be treated…..

– Incisions. Liposuction is performed through small discreet incisions. First, dilute local anesthesia is infused to reduce bleeding and intraoperative and postoperative pain. A thin hollow tube, or cannula, is then inserted through the incisions to loosen the excess fat in a controlled back and forth motion. The dislodged fat is suctioned out of the body using a surgical aspirator or a syringe attached to the cannula.

– Postoperative. In the immediate postoperative period, swelling and fluid retention appear, which gradually disappear after 2-3 weeks. During this time it is necessary to wear pressotherapy garments. Sometimes draining massages or radiofrequency application are also indicated to improve skin adaptation. The final results of liposuction are visible several months after the procedure, and will be long lasting, as long as you maintain a stable weight and good physical shape.

What are the risks of liposuction?

– Hematomas.

– Change in skin sensation that may persist.

– Damage to deeper structures such as nerves, blood vessels, muscles, lungs and abdominal organs.

– Deep vein thrombosis, cardiac and pulmonary complications.

– Fluid accumulation, swelling.

– Infection.

– Irregular contours or asymmetries.

– Irregular pigmentation.

– Need for revision surgery.

– Persistent swelling.

– Poor wound healing.

– Undulation or loose skin, worsening of cellulite.

– Swelling.

– Ultrasound thermal burn or heat injury with the ultrasound-assisted lipoplasty technique.

These complications are rare in experienced hands, so it is important to choose a skilled surgeon who specializes in plastic surgery. Should any of these complications arise, you will also know how to deal with them.

Sometimes secondary procedures may be recommended to reduce excess skin. Special considerations are needed when suctioning large quantities, usually more than five liters of fat. On the other hand, complementary treatments can also be prescribed.

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