Procedures

LAS VEGAS and HENDERSON LIPOSUCTION SURGERY

Liposuction is an excellent way to remove fat. It is not a weight loss procedure, but a body contouring procedure. Areas commonly treated with liposuction include the abdomen and hips (waistline), and inner and outer thighs utilizing a 3 dimensional approach. Other areas that are regularly treated include the upper back rolls, flanks, buttocks, upper arms, medial knees, and lower face and neck. Breast reduction in men and women can also be achieved with liposuction. Liposuction is not a skin-tightening procedure. The best candidates have good overlying skin tone, and therefore experience smooth and even skin retraction. Not everyone has great skin or tissue tone. Skin looseness, unevenness, and cellulite are common issues that affect everyone. In these patients, liposuction is commonly performed, and appearance and body contour is significantly improved, but skin retraction can be less predictable. Today, there is not yet a minimally invasive device or technique to tighten or smooth skin reliably and predictably. Skin retraction can occur irrespective of liposuction technique based on natural elasticity that is present in all patients' skin. Patient age and treatment location affect skin retraction more so than any technique.

There are various techniques to perform liposuction. Safety is essential, so standard proven safe and effective techniques are recommended. Tumescent technique is the safest. This means that a fluid solution containing epinephrine is injected into the area prior to suctioning. This distends the subcutaneous space while epinephrine prevents bleeding. Evacuation of fat can proceed with various techniques depending on surgeon personal preference, treatment area, and desired result. Not one technique is proven better than another. Dr. Brown's personal preference is Power-Assisted Liposuction, with Ultrasonic Liposuction in more fibrous areas such as the chest and upper back.

Who is a Candidate?

• Works best for people who are of normal and stable weight, but have areas of "resistant" fat that has not responded to diet and exercise
• Patients with genetic predispositions to certain bulges
• People who wish to change the contour of their body
• Individuals with body disproportion, such as a narrow upper body with wide hips and thighs (pear-shaped), or thick trunk with thin extremities (apple-shaped), to improve body contour and achieve attractive silhouettes
• Healthy patients who are mildly to moderately overweight, yet stable in size, and with realistic goals may be good candidates for surgery.
• Patients with poorer skin tone, cellulite, looseness, or unevenness of their skin may be good candidates for body contouring with liposuction, provided they have realistic expectations, understanding that their current skin condition will not change and can rarely be worsened. Skin tightening procedures such as abdominoplasty (tummy tuck), thigh lifts, arm lifts, or neck lifts can always be performed as a second stage to tighten and smooth overlying skin if desired
• Patients with "intra-abdominal" distention, bloating, or "beer-belly" are not candidates for abdominal liposuction. In these patients, fatty accumulation occurs on the inside of the abdominal wall, and liposuction only treats external fat. Weight loss with diet modification is the only way to affect appearance change in this situation

Goal of Surgery:

• To remove fat cells and bulges and improve body contour and appearance of the treated area.
• Clothing fits more comfortably and looks better. Jeans look attractive and reveal trim straight and non-touching inner thigh contours with reduction in outer thigh bulges, while maintaining female curviness. The buttocks is framed, with reduction in flanks and square-shaped behind to more projecting, rounder and compact backside. Abdomen is flatter with a narrower waistline, bra strap bulges are reduced
• Removal of "muffin-top" which are fatty deposits that undesirably project above pant lines
• Projecting medial knee fatty deposits can be reduced
• Lateral breast fullness can be reduced.
• Upper arms can be reduced so short-sleeved tops fit comfortably. Upper body appears narrower when arms look slender.
• Men with gynecomastia feel comfortable in snug tops and in bathing trunks. Abdomen is flatter and flanks are reduced
• Patients with full necks, weak chins, or "double" chins can improve neck and jaw line contour
• Liposuction is not intended for weight loss. The goal of surgery is to contour the body. If a patient desires a weight loss, he or she must do their part in maintaining a healthy diet and exercise. Weight gains after surgery negatively influence results.

Procedure Description:

• The procedure is done as an outpatient, usually under general anesthesia
• A fluid mixture of saline, local anesthetic, and epinephrine is infused into the fat. This is called tumescent fluid and it controls blood loss and fluid absorption, making the procedure very safe and well controlled. It distends the subcutaneous space facilitating safe passes of the liposuction cannula
• Small 2-4 mm incisions are made over the treatment area, and a long thin metal tube called a cannula is inserted.  Cannula sizes range from 2-4 mm, depending on the site and depth of extraction. A vacuum then extracts the fat, as passes are performed to contour the soft tissues evenly. Improvements are immediately seen and felt, and the endpoints are smooth, symmetric contours with even fatty layer thickness
• Ultrasonic liposuction is used in areas where the fat can be denser and more fibrous such as the male chest or upper back. In these areas, the cannula does not pass easily because of tissue resistance. Therefore a preliminary operative stage involves liquefying the fat with heat (ultrasound), so that the liposuction cannula can then pass with little resistance and extract the fatty tissue efficiently
• Incisions are closed with sutures, and patients are placed in snug compression garments

Postoperative Course:

• You will go home with a compression garment placed over the treated areas.  Mild drainage is to be expected through the closed incisions for 24 hours. This is the residual tumescent fluid left behind in the tissues. The garment can be removed in 24 hours, and patients are free to shower and wash normally. The garment must be worn all the time for 4 weeks after surgery. This will keep swelling to a minimum and facilitate smooth skin retraction. After 4 weeks, the garment may be weaned, depending on the amount of residual swelling present in the treated areas.
• Exercise can resume in 4 weeks as tolerated
• Expect a transient scar tissue phase beginning between 2-3 weeks post op. Firm areas of scar tissue can develop in the treated areas. It responds to massage and typically resolves over months
• Oral pain medication is prescribed for discomfort
• Because of significant bruising and swelling seen after liposuction, results may not be apparent before 6 weeks. It takes 4-6 months for final results.
• Most patients get back to work in several days to one week
• Do not gain weight after surgery or fat can come back. More dramatic results are seen with simultaneous small weight losses on the part of the patient. Follow a healthy diet with regular exercise to maintain your results
• The small access scars generally fade over the year and are inconspicuous
• Avoid tanning over the treated areas for at least 6 months. Sunscreen to treated sun-exposed areas is important.

Other Options:

• Other procedures that may enhance liposuction include tummy tuck, breast augmentation, or breast reduction

Dr. Brown is a board certified plastic surgeon, trained in safe and effective liposuction practices and techniques. Even though it is minimally invasive, it needs to be undertaken with all safety standards in place. During your consultation, Dr. Brown will advise you on what areas should be considered for liposuction so that an attractive shape is obtained and subsequently clothing looks good and fits comfortably. She will also give you an honest and straightforward opinion about whether or not the fatty deposits are amenable to weight loss and exercise, instead of surgery. Most women after pregnancies and major weight fluctuations need abdominoplasty (tummy tuck), rather than liposuction, in order to contour their abdomen and waistline. In this situation, abdominal protuberance is related to abdominal wall muscle stretch and skin stretch, in addition to fatty deposits. In this situation, all 3 layers of the abdominal wall must be addressed to affect contour improvements.

Techniques for liposuction are continuously evolving and improving. New technology must be proven safe and effective before replacing proven standards for treatment. Dr. Brown stays up to date and current with respect to all available technology and equipment, such as lasers, for liposuction treatment. Advertising claims and mass marketing of procedures and techniques by corporations may not always have the patient's best interest at heart. Dr. Brown thoroughly evaluates all new technology and incorporates only safe, effective, and reliable technology into her practice. Rest assured that we have our patient's best interest at heart, and want the best possible outcomes for all of our patients. We are looking forward to the time when we have a non-invasive device that predictably tightens skin without excisional surgery, eradicates cellulite, smoothes skin, and improves skin tone.