Fundamentally, the purpose of liposuction is not to lose weight but to smooth the body line. That is, liposuction is confined to the area of lower abdomen, buttock, thigh, upper arm of which the fatty tissue is hard to be removed despite of the exercise and dietary control.
How much fat can be removed?
In general, as fatty tissue is removed more and more, the complication is severer and graver. However, technique has been improved and large volume liposuction with minimal complication can be obtained. American society of Plastic Surgeons now recommend the maximum amount of liposuction to be 6~7000cc in single stage. More amount is needed to be removed, several times of liposuction should be fragmented to perform. Deep vein thrombosis, heart disease, and hematologic abnormality should be notifed before the surgery.
How can you do it?
If the area of targeted suction is narrow, local anesthesia can be performed. However, if the large area or multiple sites at the same time should be suctioned, general anesthesia is recommended. Small incision is made and via this incision site, tumescent solution is infiltrated then the suction can proceed through the suction syringe. If too much volume is removed, temporary hypothermia and anemic symptom may be intervened so that one or two days of hospitalization are recommended.
Through the suction tube with negative pressure, liposuction is carried out. This is the classical method and still be widely used. In some part, syringe can be applied to make suction on the thin fatty layer such as face, neck, and ankle.
Ultrasound-assisted liposuction (UAL)
UAL liquefies the fatty tissue and suction of aspirates ensues. With UAL, bleeding can be controlled with minimal amount and can reduce the skin irregularity.
After liposuction, immobility may rather have adverse effect on the cardiopulmonary function. Therefore, ambulation had better be encouraged right after the next day of the liposuction. Drains are removed within 1 to 2 days if they are inserted. Stitch out is made in 1 to 2 weeks. Patient can be back to the daily activity in postoperative 3rd to 4th day and can go on social life. Hot pack, sauna, and severe exercise should be avoided for 2 to 3 weeks. Bruise, swelling, and temporary sensational loss are restored as time goes by. For 3 to 6 months, specially designed pneumatic stocking or garment is worn so that decrease of edema is accelerated. Body contour gets better as it goes and patient is supposed to be satisfied with the surgical outcome if only the patient do not have extreme expectation.
How long does the surgical result last?
Liposuction is the procedure of removing the fatty tissue. As the numbers of fat cell are not known to be increased after the adolescent period, if the regular exercise and dietary control is accompanied, permanent effect can be expected.
Abdominoplasty & skin excision
As one grows old and has weakened power of abdominal muscle or has redundant and sagged skin after abrupt weight reduction, redundant and irregular surface of skin result in the folded wrinkle. In this case, plication of abdominal muscle and excision of skin can make good result. General anesthesia is necessary and 2 to 3 weeks of convalescent period are necessary. After the surgery, thin scar is left under the line of underwear. Initially, the red scar is visible. However it grows blurred and looks indistinct.
Bulging muscle of calf is composed of calf muscle and subcutaneous fatty layer. This makes it look thick calf. Calf reduction comprises muscle reduction and liposuction. Like other muscular structure, calf muscle is hypertrophied with repetitive usage and degenerated without using. Calf reduction takes advantage of this principle. Tiny incision on the posterior knee is made and nerve innervated to the calf muscle is blocked to make muscle thinner. Surgical effect appears slowly over 2 to 3 months. Instead of permanent blockage of nerve, injection of botox can replace it for the temporary similar effect. Thick calf due to subcutaneous fatty layer can be managed by the luiposuction. Most of the cases, muscle reduction combined with liposuction is able to improve the outcome.
Body contouring after abrupt body weight loss
Various body contouring can help the situations like postbariatric surgery, following the abrupt body weight loss, postpartum redundant skin left on the whole body. However, in case of postbariatric surgery, surgical intervention should be postponed until the patients’ pattern of diet and nutritional state is stabilized and psychological preparation is ready. In most cases, surgery is taken with several steps. In female patient, body contouring begins with abdominoplasty, reduction mammaplasty and surgery on the arm, thigh, and buttock follows step by step. In case of hernia, concomitant herniorrhaphy is planned.