Liposuction /Abdominoplasty (Tummy Tuck)

What is the most common form of body contouring ?

The most common form is liposuction. Liposuction is a procedure where fat is suctioned through a hollow tube connected to a vacuum out of the body.

Is there any truth that when one has liposuction, the fat shows up in other parts of the body?

We are all born with a set number of fat cells so when liposuction is performed, you get some of those cells out. So the area that has had the fat suctioned out of it is less likely to gain weight or increase in fat because there are fewer fat cells in the area. However, if you does not gain weight then there will be no relative increase in fat elsewhere.

Does bovine promote breast growth ?

I am not sure you what mean by bovine. I assume you mean bovine collagen and if that is the case, I know of no such study that indicates that breast growth increases with bovine collagen.

Is it necessary to have skin removed or tucked after liposuction ?

The ideal patient for liposuction is someone who is in good shape, but has isolated fat deposits. In those patients, there is usually no need to remove skin or tuck it. However, there are patients that have a lot of extra skin and fat that is not amenable to liposuction alone. In those patients, we usually will need to remove skin as well as fat to get the improvements in contour.

Is it possible to get rid of cellulite on the back of the legs or elsewhere ?

Cellulite is a condition where there is pitting of skin and tends to be genetic in nature. It is almost exclusively present only in females. Liposuction does not improve cellulite. Some lifting procedures like a buttocks lift or a thigh lift will sometimes reduce cellulite.

How painful is the liposuction procedure ?

The amount of discomfort that patients have with liposuction is dependent on a number of factors. If the liposuction is limited to a small area, it is less likely to cause much discomfort. Thus, the more extensive the area liposuctioned the more discomfort you will experience. Another factor is you's own tolerance to discomfort. Some people have very little discomfort after liposuction, while others require significant pain medication to alleviate their pain. On the average, you feels sore for 7 to 10 days.

How much fat can be removed during one liposuction ?

There has been a change in the attitude of many surgeons when it comes to how much liposuction should be accomplished in one procedure. The recommendation by the American Society of Plastic Surgeons is to limit the maximum amount of liposuction to 5 liters. If that 5 liters limit is surpassed, it is recommended that you be admitted to a medical facility for observation and management of fluid.

How long does the procedure take, and is it an outpatient procedure ?

The length of time the procedure takes depends on what you are trying to accomplish. For example, if you are only doing liposuction to the outer thighs, that will take 1 hour of operating, and it is an outpatient procedure. On the other hand, if you have a tummy tuck, this will require 4 hours of operating and you is usually kept in the hospital one night. In the largest procedure done for body contouring, which is called Belt Lipectomy, tissue is removed in a circumferential fashion all the way around the belly and back. This procedure can take 6 to 8 hours to perform and may require hospitalization for a number of days.

What is involved with a tummy tuck ?

A tummy tuck is a procedure that is utilized to flatten out and tighten the tummy usually in women after they have had a couple of babies. These patients will usually present with excess skin of the belly, as well as fat excess and a weak abdominal muscle wall. In some of these patients, if their stretch marks are all located below the belly button, then they can be removed. This is because in a traditional tummy tuck all of the skin from the belly button to the hair bearing area is removed and the remaining skin is stretched down to the level of the hair.

Can anything be done for excess tissue on other parts of the body other than the stomach ?

For the arms, many people will present with excess skin and fat from the elbow up. A procedure called brachioplasty is performed where the scar is along the length of the upper arm, but is hidden when the person has his or her arms by their side. Another area where people may benefit from body contouring surgery is excess tissue in the back or in the breast area.

How long is the recovery period after a "tummy tuck" ?

The recovery period after a tummy tuck is somewhere around 7 to 14 days. Usually we ask you to take anywhere from 2-1/2 to 3 weeks off of work.

Who is a good candidate for belt lipectomy ?

At the University of Iowa, we have one of the largest series of Belt Lipectomy in the world. We found that there are 3 groups of patients that can be helped by this operation, which removes tissue all the way around front to back. It improves the following areas: it flattens out the tummy, lifts the outer thighs, lifts the buttocks, gives you a deeper curve in the area of the hips and reduces back rolls. The largest group of patients that benefit from this surgery are those who have lost a significant amount of weight on the order of 100 to 200 pounds. Although these patients have either lost that weight secondary to stomach stapling surgery or an aggressive exercise and nutrition program, they still have a lot of excess skin and fat. The Belt Lipectomy procedure removes all of this excess and resulting in a more normal body appearance. The second group of patients that can benefit from this surgery are those who are about 30 to 40 pounds overweight. Those patients will also get the benefits that we talked about. The third group that can benefit from this surgery are people who are not overweight at all, but desire a very significant improvement in their body contour.

Are you restricted to certain activities, special clothing, etc ?

After surgery with a tummy tuck, you should not straighten up at the waist for approximately 7 days, and they are to avoid heavy lifting or exercise for 3 to 6 weeks.

Dr Khanna, are there areas of the body you would not perform liposuction ? Is the inner thigh one area ?

There are areas that are less amenable to liposuction, and, as your question states, inner thighs are bad areas to liposuction aggressively. In general, the buttocks itself is not liposuctioned. We liposuction around it but very infrequently will we liposuction the buttocks itself. The upper arm from the elbow down is not liposuctioned and, in general, the face itself is not liposuction, although the area under the chin is a common area where liposuction is utilized.

What criteria does the plastic surgeon have to meet to perform liposuction? Is there a place to check certifications ?

It is always a very tough question to answer who is and who is not qualified to perform liposuction or any other cosmetic procedure. Most recently trained plastic surgeons learn liposuction in their training. Many of the older surgeons have learned it later in their careers. I would suggest that a good way to address the question of qualification is to directly ask your physician if they are board certified plastic surgeons and if they perform this procedure on a regular basis. I would also ask the surgeons if they have ever had any complications. All surgeons have complications and if you are given the answer that they have never had complications, you might want to try another opinion. A very good method to check whether surgeons have proper certification to perform any surgery is to find out if they have regular hospital privileges to perform those procedures. The reason for that is that hospitals give out privileges based on the physician's training. So the hospital has done the checking for you. It is important that the hospitals we are talking about are regular hospitals, and not surgery centers.

What complications can one expect with liposuction ?

As with any other surgical procedure, liposuction can cause possible complications. Infection and bleeding are common complications of any surgery. Specific complications related to liposuction include seroma formations which is a fluid collection in the area of the liposuction, ridging which is waviness of the skin from the liposuction, unevenness, too much removal of fat, too little removal of fat, and in some very unusual situations loss of skin. There are reported cases of even death from liposuction where very large amounts of fat were removed in one operation, and you was not monitored. Overall, however, liposuction is a very safe procedure and is the most commonly performed cosmetic procedure. There are some other complications that are fairly unusual, and I will not include them here.

What is ultrasonic liposuction ?

Ultrasonic liposuction fits into two categories. No. 1 is internal ultrasonic liposuction where the liposuction tube has a probe at the end of it that emits ultrasonic waves, which cause the emulsification of fat. Emulsification of fat is similar to making fat more liquid so that it can be suctioned. This is especially helpful in liposuctioning fat that is very thick or scarred. The second way that ultrasonic technology can help with liposuction is external ultrasonic liposuction. With this method, the area to be liposuctioned an external ultrasonic probe is applied to the skin leading to internal emulsification of the fat. The emulsified fat is then suctioned in a routine fashion. The probes used in external ultrasonic liposuction are similar to the probes used to perform ultrasound examination of a pregnant woman. In this case, however, ultrasound energy is much higher.

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