Liposuction

Introduction

Liposuction is a surgical technique that removes excess fat deposits situated between the skin and the muscles, thus improving body’s contour. Small stainless steel tube, called “cannula”, is the instrument that is used in the liposuction procedure. One end of this cannula is introduced into the fat to be removed, while the other end remains connected to a powerful suction pump. Fat is removed through small channels created by the cannula through the fat tissue because of the suction applied. These channels get collapsed post-surgery, thus endowing the patient with an enhanced body shape.

Surgical Procedure

The concept of liposuction is surprisingly simple. Liposuction surgery can be performed painlessly in multiple ways- by local or general anaesthesia. The success of this procedure is based majorly on patient’s satisfaction about the end results, safety and comfort of the patient, and also the quality of the outcomes. The only deciding factor that creates a distinction is the technique used by liposuction surgeons. The surgeon’s specialty is not as important as the surgeon’s technique, experience and attitude toward safety.

Various techniques used in liposuction surgery:

1. Tumescent Liposuction- Tumescent means bloated/swollen and firm. The targeted tissue becomes tumescent on injecting a large amount of diluted local anaesthetic like-lidocaine and a blood capillary constrictor like- epinephrine into subcutaneous fat. This technique utilizes local anaesthesia in large volumes on the subcutaneous fat and thus allows liposuction totally by local anaesthesia. It eradicates the need for general anaesthesia and also the need for intravenous sedatives. In short, this technique for liposuction

1. 1. provides local anaesthesia

1. 2. constricts blood capillaries and prevents surgical blood loss

1. 3. provides fluid to the body by subcutaneous injection so that no intravenous sedatives are required.

2. Ultrasonic Assisted Liposuction (UAL) – This technique requires the use of a large volume of tumescent fluid along with a metal paddle or probe to deliver ultrasonic energy and heat into subcutaneous fat.

2. 1. Internal UAL describes a technique where a long solid or hollow metal probe, is inserted into fat through a large incision. Surgeons performing internal UAL procedure mostly give general anaesthesia or heavy intravenous sedation to their patients. The initial reports of internal UAL were unrealistically enthusiastic. But, it has shown to cause full-thickness, skin burns and severe scar development, so it is largely been abandoned.

2. 2. External UAL also requires the tumescent fluid and uses a metal paddle to direct ultrasonic energy into subcutaneous fat.

Minor Complications:

Any undesirable result of surgery can be categorized as a surgical complication. Ultimately any result that produces an unhappy patient is a complication. Minor complications do not cause threat to patient’s life.

The causes for minor complications include certain random factors such as a patient’s wound healing ability, incorrect judgement by the surgeon, patients’ failure to follow instructions, or unexpected allergic reaction to a drug.

Skin Irregularities and Depressions caused by liposuction:

• Considerable amounts of irregularities and depressions of the skin are frequent result of the surgeon’s negligence to detail. Such as, if a liposuction surgeon attempts to do too much on a single day, and becomes fatigued, then it calls for distraction in detailing and undesirable cosmetic outcomes.

• As explained above, liposuction cannula is steel tube inserted through an incision in the skin that is employed to pump out the fat. The size of the liposuction cannula can control the smoothness of the skin after liposuction surgery. Surgeons who do total-body liposuctions tend to use larger cannulas. The use of large cannulas may create irregularities more often as compared to microcannulas (outside diameter < 3 mm).

Unrealistic Expectations:

Unrealistic expectations from a liposuction procedure are the most common source of disappointing liposuction outcomes.

It is realistic to expect a significant improvement, but it is unrealistic to expect perfect results. Unrealistic expectations from a liposuction procedure are the most common source of disappointing liposuction outcomes. If any patient keeps totally unrealistic expectations from a liposuction, then it is quite difficult for a surgeon to obtain results to make the patient satisfied. To avoid such consequences, surgeons must ask what the patient expects from the liposuction procedure. Patients must honestly state their hopes and expectations with the surgeon. Patients must not expect perfection. Surgeons should also clearly state the amount of improvement that is likely to be achieved.