BODY CONTOURING

Following significant weight loss, including that achieved by diet, exercise, gastric bypass, or gastric banding, the patient typically has significant areas of skin excess. This commonly includes excess skin of the abdomen, breasts, arms, and thighs. Plastic surgeons address these problems with many different potential options, including abdominoplasty (tummy tuck), breast lift or reduction (or in the case of males, gynecomastia excision), upper arm lift, medial thigh lift and lower body lift. These patients may also be candidates for other procedures including liposuction and facelift. Your plastic surgeon can discuss with you the various surgical options to optimize your appearance following weight loss.

From:http://www.columbiasurgery.org/divisions/plastic/body_contouring.html

BODY CONTOURING PROCEDURES

GENERAL INFORMATION ABOUT LIPOSUCTION

Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as "lipoplasty" or "suction lipectomy," has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping many plastic surgeons to provide selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don't respond to traditional weight-loss methods.

If you're considering liposuction, this web site will give you a basic understanding of the procedure -- when it can help, how it is performed and how you might look and feel after surgery. It won't answer all of your questions, since much depends on your individual circumstances. Please ask your doctor if there is anything about the procedure you don't understand.

THE BEST CANDIDATES FOR LIPOSUCTION

To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. It's important to understand that liposuction can enhance your appearance and self confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.

Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.

TUMESCENT TECHNIQUE

If your surgeon recommends the tumescent technique...

The tumescent technique is a relatively new liposuction method that can reduce post operative bruising, swelling and pain. Because blood loss is minimized during tumescent liposuction, use of the technique reduces the chance that a blood transfusion will be needed.

In the tumescent technique, areas of excess fat are injected with a large amount of anesthetic liquid before liposuction is per-formed. The liquid causes the compartments of fat to become swollen and firm or "tumesced." The expanded fat compartments allow the liposuction cannula to travel smoothly beneath the skin as the fat is removed.

CANDIDATES FOR TUMESCENT LIPOSUCTION

Any person who is a candidate for traditional liposuction is also a good candidate for the tumescent technique. Although the technique can be used on any area of the body, it is commonly used on areas that require enhanced precision, such as the face, neck, arms, calves and ankles.

Individuals who have large areas of excess fat may also be good candidates for tumescent liposuction.

ULTRASONIC ASSISTED LIPOSUCTION

You may be a candidate for ultrasonic liposuction (UAL) if you have excess subcutaneous fat, which is resistant to diet and exercise or if you wish to change the contours of your body. Commonly involved areas are the anterior part of the neck (under the chin), upper arms and armpits, male chest/breasts, trunk, abdomen, waist, hips, thighs, inner knees, calves, and ankles. Patients desiring permanent improvement in contour abnormalities caused by excess fat may also desire ultrasound liposuction.

The use of UAL allows safer removal of larger amounts of fat than with standard liposuction. This increase in safety is due to the reduced amount of blood removed with UAL. This means that UAL can be very useful to moderately overweight individuals even though UAL is not a weight loss method per se.

Ultrasound assisted liposuction is intended to improve the contour and proportion of the treated areas, resulting in a more flattering figure or physique, in or out of clothing.

The procedures are done on an outpatient basis. General anesthesia is appropriate for UAL. Small suction tubes (cannulas) are inserted through very short incisions placed in inconspicuous locations near the fat deposits, and excess fat is removed. If extremely large volumes of fat are to be removed, you may be asked to donate one or two units of blood and take supplemental iron before surgery. Your own blood may then be used as a transfusion at the end of surgery. (The frequency of need for this type of transfusion is decreased by using UAL.)

The patient goes home with a compression garment covering the treated areas. Compression is advised for about a month as it helps reduce swelling and helps you achieve the final result more quickly. Once pain and soreness decrease, it is frequently more comfortable to wear Iycra or spandex exercise pants. Initial discomfort is easily controlled with oral medication. The advantages of UAL are reduced blood loss, decreased bruising, possible reduction in post?operative discomfort and overall faster healing. Bruising and swelling usually subside in 2-4 weeks. The final result takes shape over 2-3 months.

Additional procedures that may enhance the result are of ultrasonic assisted liposuction are Tummy Tuck (Abdominoplasty), Breast Reduction, Breast Lift, Breast Augmentation, Thigh Lift, or Buttock Lift

Be frank in discussing your expectations with your surgeon. He or she should be equally frank with you, describing the procedure in detail and explaining its risks and limitations.

This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment. The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

POWER ASSISTED LIPOSUCTION

Lipoplasty (liposuction) has proven to be a very popular surgical cosmetic procedure; see current American Society for Aesthetic Plastic Surgery (ASAPS) statistics. Power-Assisted Lipoplasty (PAL) is a relatively new technique, approved for general use by the FDA in December 1998, and is not yet widely used. Most lipoplasty procedures are performed using traditional suction-assisted lipoplasty (SAL) and certain procedures can benefit from ultrasound-assisted lipoplasty (UAL).

TECHNIQUE:

In PAL, a reciprocating cannula, or hollow tube (powered by gas or electricity) powers through tissue and vacuums out fat and fibrous or scarred tissue reportedly with minimal effort. The back and forth motion of the tip of the cannula facilitates passage through tissue.

BENEFITS:

OTHER CONSIDERATIONS:

SUCTION ASSISTED LIPOSUCTION

The traditional method, by which the surgeon removes fat by inserting a small, hollow tube (cannula) connected to a vacuum pressure unit, directing the cannula into areas to be suctioned through tiny incisions.

WET & SUPER WET LIPOSUCTION

WET LIPOSUCTION

This is the most commonly-used technique. Once the anesthetic has taken effect, the surgeon injects a fluid containing local anesthetic and other components, such as adrenaline, into the fatty area. This helps reduce bleeding, bruising and swelling and makes it easier to remove the fat cells.

An incision is made in the skin and a thin metal tube called a cannula is inserted. The cannula is moved about vigorously within the fatty tissue while suction is applied from a vacuum pump or a syringe. For larger areas, more than one incision may be used so that the cannula can reach all the fatty deposits that are being targeted.

Once the required amount of fat has been removed, the cannula is taken out and the incision(s) are stitched close. A variation of the wet technique is "tumescent" liposuction where a larger volume of fluid is injected.

SUPER-WET LIPOSUCTION

In the super-wet technique, a saline solution containing a local anesthetic and adrenaline is injected into the area to be treated, which makes the fat deposits easier to break up and extract. This extra fluid also minimizes trauma to the surrounding tissue, reducing swelling and post-operative pain. The administration of adrenaline also decreases bleeding during surgery, further reducing risks.


VASER LIPOSUCTION

In response to the problems of UAL, the VASER assisted liposuction (VAL) system has recently become more popular. In this procedure, the cannula has been redesigned and produces about 25 percent less mechanical and thermal energy, reducing the risk of burns and injury. This is accomplished by using short, intense bursts of energy which emulsify the fat like in UAL, but by reducing the average energy over time, the risk of burning the skin is much lower. In addition, the VASER cannulas are about half as thick as traditional ones, reducing the opening incisions to about 3-4 mm, as opposed to about ¼ inch for non-VASER procedures. Due to the price of the equipment and the lack of doctors using VASER liposuction, the cost of VAL may be greater than other forms of liposuction.


MICRO LIPOSUCTION

Micro liposuction refers to the the removal of small areas of fat through tiny tubes and very small incisions. Microliposuction is commonly performed on the face, especially the cheeks, neck, under the chin, and the jowls. When liposuction is done on other small pockets of fat using tiny cannulas, it may also be referred to as "micro liposuction".

Cannulas used to remove the fat range in diameter from 1.5mm to 6 mm in diameter. In general, smaller cannulas are preferable to larger ones for smaller areas (such as with microliposuction), and for more refined contouring. Larger cannulas speed the surgery for the doctor, but may put the patient at greater risk for rippling and lumpiness. Sometimes, a larger cannula will be used initially to remove the bulk of the fat, and then progressively smaller cannulas employed for fine contouring and sculpting.


ABDOMINOPLASTY - TUMMY TUCK SURGERY

If you're considering abdominoplasty...

Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

If you're considering abdominoplasty, this will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.

THE BEST CANDIDATES FOR ABDOMINOPLASTY

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

THIGH LIFT

You may be a candidate for thighplasty if you have experienced a loss of skin elasticity of the thigh, hip, or buttock areas. You may also desire this procedure if your skin in the thigh area is saggy, has an orange peel, flabby and/or dimpled appearance. The procedure may also be indicated if your thigh appearance improves dramatically when you lift the lax skin. If you are self-conscious about your lower body appearance you may also want to look into this procedure. The procedure is intended to produce tighter, more attractive thigh and buttock skin with improved contours. It is also intended to decrease irregularities in skin surface.

The procedure is performed under general anesthesia on an outpatient basis unless otherwise advised by the surgeon. Wide variations in the design of the incisions to meet clothing or personal desires are possible. Lifting the inner thighs requires only short incisions extending from the anterior part of the thigh/groin crease around to the buttock crease. Lateral or anterior thigh lifts can be performed as separate procedures if desired. The buttocks can be lifted with upper or lower scars. The doctor will show you what specific procedures are available to solve your particular problem.

The patient is placed in a compression garment (similar to a long?line elastic support girdle) at the end of surgery to reduce swelling and assist in the natural shrinking and tightening of the skin. With smaller thigh lifts, initial discomfort is usually easily controlled with prescription pain medication. With larger thigh lifts, one or two nights care in a skilled nursing facility or hospital are usually required. This allows for pain injections, intravenous catheters, etc. Bruising and swelling usually subside within a month, strenuous activities are usually possible in 6 weeks and almost all symptoms are gone in 4-6 months.

Additional procedures that may enhance the result include Liposuction, Breast Enlargement and Tummy Tuck.

This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment. The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

The Above Information From: http://www.lookingyourbest.com/info/thighlift.php

Call Helen Elliott today for a complimentary & confidential Body Contouring Consultation consultation toll free at, (888) 433-9091. Direct Line: (310) 285-0771

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Let us help you find your "Dr. Right."

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