Plastic surgeries

Liposuction

Preface

Appropriate for slimmer people with bordered fat-pads. In any case liposuction can’t substitute for natural weight loss.

If planned 2 – 3 suction locations a patient can choose from the outpatient procedure "Tumescent method" under local anaesthesia or under general anaesthesia with hospitalisation till the next day at the clinic. In case there are more locations planned for suction or if the locations are extensive then during "Tumescent method" there is a risk of anaesthesia overdose, hence the procedure must be done under local or general anaesthesia.

The principle of the procedure is the inserting of a cannula (a thin tube with holes at the end) through tiny incisions around the fat pad. Cannula moves in the fat, which causes a break up of fat cells. Its content is drawn into the cunnula. This basic principle can be modified by means of various devices.

The most frequent modifications:

  • Ultrasonic liposuction – breaking up the fat cells through cannula is simplified due to the ultrasound. Nowadays, the use of ultrasound for a liposuction is potentially considered to be dangerous to health.
  • Vibration liposuction (Power assisted technique) – a device, which is in the handle of the cannula, produces in-and-out movement at the cannula, makes doctor´s work and the movement of the cannula easier.
  • A laser liposuction - A laser beam that is inserted into the cannula through the optical fibre simplifies laser liposuction – breaking up the fat cells. Very thin cannulas are used for this method.
  • Non-invasive methods (fat is to be dissolved / removed through intact skin) by means of ultrasound – Ultrashape, Ultracontour device or radio-frequency undulation Accent XL)
  • Injection-Lipolysis – the fat is infiltrated with injections of special substance that are to remove the fat by influencing fat metabolism.

I perform only classic liposuction when the fat pad is saturated / infiltrated with a special solution that makes the liposuction easier. The solution can contain admixture of local anaesthesia if the procedure is done without general anaesthesia. Afterwards the fat is sucked through the cannulas with 3-6 mm in diameter.

Who is the procedure suitable for

The procedure is not appropriate as a substitute of the diet or for general loss of weight. Fat suction from all body surfaces is not possible. Ideal candidate is the one with bordered fat-pads that are formed mainly on the stomach, hips, inner or outer sides of thighs, under the chin and elsewhere. While losing your weight you reduce your weight all over your body surface except for problematic parts, then the liposuction makes sense and it is possible to expect a good result.

Before the operation, consultations, setting the date of the operation

Consultation (active) is necessary as the first step when deciding for the procedure because of the greatest difference between expected result and real possibilities of the liposuction method. Consultation should precede the operation. It is necessary to make an appointment for the consultation by telephone. If it is really difficult for you to come for the consultation then it is possible to do the "consultation" by sending photographs via e-mail on info(zavinac)stepan-plastika.cz or in different way "at the distance". Logically, this way is connected with a certain source of risk for misunderstanding and is appropriate only for an emergency solution. Consultation is done just before the procedure then.

No special preparation is needed for a healthy person. If the procedure is done under general anaesthesia, the pre-operation examination is needed. If the procedure is done outpatiently it is necessary to eliminate a blood clotting disorder in a scope of a consultation examination or through laboratory investigation.14 days before the procedure it is not good to take any medicine containing acetylsalicil acid (Acylpyrin, Anopyrin). Patients who take anti-coagulants are to be considered carefully. It is not suitable to undergo the operation 3 days before and after menses. Operation can be performed during the whole year ,but considering the necessity of wearing compression garments colder months are more appropriate.

If the operation date isn´t set within the consultation, it is possible to make an appiontment for a consultation by telephone. A deposit is to be paid for a date reservation.

How the procedure is performed

It is appropriate to come for a procedure dressed in loose-fitting clothes, so it is possible to put on liposuction garments with bandages under.

Outpatient procedure under local anesthesia:

After the marking of the exact extent, location and photo documentation of the locations from which you wish the fat to be removed, the fat is injection-infiltrated with a solution with admixture of local anesthesia. The substance prevents from a painful procedure and makes the suction easier. As soon as the suctioned part is completely numb, a cannula is inserted into a tiny incision on a skin nearby. The cannula with the smallest diameter is chosen to prevent from formation of roughness The cannula is moved in the fat in the way of "a ray of light-movement" and the dull end of cannula breaks up membranes of fat cells. The fat flows out of them and is suctioned by holes in cannula by means of vacuum of a liposuction pump. Not suctioned rest of the fat is gradually removed in a natural way. After the procedure the incisions are stitched or strapped with a special plaster substituting stitches. Stitches are necessary to be removed on the 10th-14th day.

Procedure under general anesthesia:

In case there are more locations planned for the suction or if the locations are extensive, the consumption of local anaesthesia might get over a safe amount that might result in anaesthetic overdose. That’s why it is necessary to provide general anaesthesia to avoid painful procedure. The general anaesthesia can be done outpatiently and after it subsides, you go home. Or you can stay till the next day, which is necessary in case when the operation is of such an extent that might influence general health state of the patient. The way of the performing is the same with only one difference – the anaesthesia is not added into the solution and you sleep during a whole procedure.

Post-operative course and recommendations

It is necessary to aarrange a lift home after the operation. After the outpatient procedure another person should be present in case of any difficulties. The next day after the procedure you put off liposuction garments and all layers of bandages in horizontal position in bed. The bandages will be soaked with the rest of liposuction solution, which flows out through the skin and it is coloured by blood. After you can get up and have a shower. After having showers disinfect the incisions and strap them with a plaster with pad. After liposuction it is possible and necessary to have a shower in common way using common soaps or shampoos. Always disinfect and strap plasters over incisions.

Liposuction garments must be worn all the time especially during the first days with necessary breaks for a shower and using the toilet. Recommended period for wearing the garments is individual and it keeps between 3 to 7 days.

In the first post-operative days the result of the procedure is covered with post-operative swelling that the suctioned parts can be even more extensive than before the procedure. Bruising is very common. Pain is not great and it reminds of bruising or contusion. Temperature of 38 C is not exceptional. After 3 weeks a suctioned fat of there starts to be visible but only after 3 months one can talk about the final result.

During the first 14 days a quiet in bed without any greater burden or movement activities is appropriate. After the procedure it is possible to go to work the next day but you should count on certain difficulties eg. when sitting. After 14 days, fitness exercises are recommended to be started.

After the performing of the liposuction, the fat is not going to be deposited into suctioned location like before, nevertheless; it is necessary to keep principles of healthy regime and adequate food.

Risks of the operation

Formation of asymmetries, roughness, acceleration of cellulitis, infection, loose skin. Dissatisfaction caused by unrealistic expectations towards the liposuction is the most frequent of all cosmetic procedures.

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