The concept of liposuction is surprisingly simple.
Liposuction is a surgical technique that improves the body's contour by removing
excess fat from deposits located between the skin and muscle. Liposuction
involves the use of a small stainless steel tube, called a cannula (from the
Latin word for reed, tube, cane). The cannula is connected to a powerful suction
pump and inserted into the fat through small incisions in the skin. Fat removal
is accomplished as the suction cannula creates tiny tunnels through the fatty
layers. After surgery, these tiny tunnels collapse and thus result in an
improved body contour.
Liposuction is defined as the
removal of fat from deposits beneath the skin using a hollow
stainless steel tube (called a cannula) with the assistance of
a powerful vacuum. Liposuction can be accomplished either with
the use of general anesthesia, or with heavy IV sedation, or
totally by local anesthesia. This web site considers both the
benefits and the potential dangers of local anesthesia and of
systemic anesthesia.
Tumescent
liposuction refers to a technique that uses large volumes of
very dilute local anesthesia that is injected into the fat
causing the targeted areas to be come tumescent, or swollen
and firm. Local anesthesia is widely regarded as the safest
form of anesthesia. Because local anesthesia persists for many
hours there is no need for narcotic pain medications after
surgery.
Modified
tumescent liposuction refers to a combination of tumescent
local anesthesia plus some form of systemic anesthesia
(general anesthesia or heavy IV sedation). Because general
anesthesia or heavy IV sedation can be dangerous, they must be
administered by an anesthesiologist.
There are many
ways to do liposuction, for example liposuction can be
accomplished painlessly either totally by local anesthesia or
with general anesthesia. In the realm of liposuction, maximum
speed and maximum volume of aspirate are not criteria for
excellence. Ultimately, excellence is measured in terms of
patient happiness which is a function of safety, patient
comfort, finesse, and quality of results. The important
distinction between liposuction surgeons who are board
certified is the liposuction technique that they use. The
surgeon's specialty is not as important as the surgeon's
technique, experience and attitude toward safety.
Liposuction
complications are often the direct result of lack of caution,
poor judgment, over confidence, ignorance about pharmacology,
or adherence to faulty dogma. This web site discusses these
traits, and explains how to reduce the risk of liposuction
surgical complications. The "Art of
Liposuction"
Liposuction is a
medium of artistic expression that displays itself in (1) a
practical application of scientific knowledge, (2) the
production of what is beautiful, (3) a perfection of
workmanship, (4) a perpetual quest for improvement in
technique, and (5) a skill attained through clinical
experience, and above all (6) making people feel happy about
what they see in the mirror.
This web site
asserts that artistry and safety depend on each other. The
word "art" implies skill and mastery of a technique. In order
to master an artistic liposuction technique, the surgeon must
have the skill and intelligence to avoid exposing patients to
unnecessary dangers. The true artist provides better results,
and uses the safest technique and never forgets the duty to
"first, do no harm." For example, even if a patient wants to
have a large volume of liposuction accomplished in one
session, the artist convinces the patient that serial
liposuction procedures are safer and ultimately yield better
results. It is not artistry to take unnecessary risks or push
liposuction to the limits of safety.
Risks of Liposuction must be well
understood by all prospective liposuction patients. This web
site emphasizes the need to constantly be aware of safety
issues. In order to minimize the risk of liposuction, the
patient must:
Too
much liposuction (excessive volume of aspirated fat, or
excessive number of areas treated). Excessive surgical
trauma (excessive liposuction) is dangerous and is an
important cause for serious liposuction complications.
Unrelated surgical procedures on the same day as
liposuction are unnecessary. Prolonged exposure to
anesthesia is dangerous and is an important cause for
serious liposuction complications.
Disfiguring skin irregularities and depressions are
frequently the result of the surgeon's inattention to
detail. For example, if a liposuction surgeon attempts to
do too much on a single day, and becomes fatigued, the
result may be an inattention to detail, and undesirable
cosmetic results. A liposuction cannula is a stainless
steel tube inserted through an incision in the skin that
is employed to suction the fat. The size of the
liposuction cannula can influence the smoothness of the
skin after liposuction. The use of large cannulas tend to
create irregularities more commonly than microcannulas
(outside diameter less than 3 millimeters). Surgeons who
do total-body liposuction tend to use larger cannulas.
The tumescent
technique for liposuction is unquestionably the safest form of
liposuction. When tumescent liposuction is done correctly (not
excessively) it is a very safe procedure. For example, there
have been no reported deaths associated with tumescent
liposuction totally by local anesthesia. Even when general
anesthesia is combined with the tumescent technique,
liposuction is quite safe provided the volume of fat removed
and the number of areas treated during a single surgery is not
excessive. The dilute epinephrine contained in the tumescent
anesthetic solution profoundly shrinks capillaries and thus
virtually eliminates surgical blood loss.
The tumescent
technique permits the use of microcannulas which in turn
yields smoother cosmetic results. Traditional liposuction
cannulas (stainless steel tubes) have a relatively large
diameter and remove fat rather quickly. However with the use
of large cannulas (diameter greater than 3 millimeters) there
is an increased risk of irregularities and depressions in the
skin. Microcannulas, with a diameter less than 3 millimeters,
allow fat to be removed in a smoother and more uniform
fashion. Some surgeons prefer larger cannulas because it
allows liposuction to be done more quickly.
After tumescent liposuction
there is a certain amount of blood-tinged local anesthetic
solution that remains under the skin. This excess fluid is
either slowly absorbed over several weeks into the blood
stream, or it can be rapidly removed by drainage through skin
incisions and absorbed by special absorptive pads (HK Pads).
Rapid drainage
of blood-tinged anesthetic solution out of incision sites,
accelerates the rate of healing, and reduces post-operative
pain swelling, and bruising. Post-liposuction drainage of
blood-tinged anesthetic solution can be maximized by 1)
leaving incision sites open and not closed with sutures, 2)
placing several adits (1.5 mm tiny round holes) in the skin to
encourage drainage, 3) placing HK Pads on the skin to absorb
the drainage, and 4) wearing spandex compression garments to
encourage drainage.
Consultations about *Liposuction™ can usually be arranged
within two or three weeks simply by calling our special
*Liposuction™ line at 336 659-2663 or Toll Free:
1-877-WE BOTOX (932-6869).
Treatment or a skin test can be done the same day as the
consultation, if you wish.
Our staff
can take the time to discuss your wishes and options,
and answer your questions. No referral is required.
Carolina Laser & Cosmetic
Center
Anne
L. White, M.D.
Premier Physician, Botox
Cosmetic Physicians Network
3000
Bethesda Place, Ste. 601
Winston
Salem, NC 27103
(336) 659-2663 or
1-877-WE BOTOX (932-6869)
*All prices for treatments or products are subject to
change without notice*
