Liposuction Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Although liposuction is not a substitute for dieting and exercise, it can remove stubborn areas of fat that don't respond to traditional weight-loss methods.   The patient must have realistic expectations about what the procedure can do. The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. The patient should be physically healthy, psychologically stable and realistic in expectations. Age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.   At the initial consultation, the surgeon will examine the patient and decide whether liposuction is going to be beneficial to the patient or some other modality of treatment would be a better option.   Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.   What to expect from a Facial Implant Facial implants can enhance your appearance and bolster your self esteem. If you are looking for improvement, not perfection, in your appearance and are realistic in your expectations, you may find that a facial implant is the right choice for you.   Plastic surgeons will frequently use such implants to bring better balance to the features of a younger patient. For instance, a teenage girl may want her nose reshaped or her chin brought forward so that these traits are better proportioned. The more mature patient may choose to have an implant placed in conjunction with another cosmetic procedure. For example, during a facelift, a patient may wish to have implants placed over the cheekbones to help restore a more youthful appearance. Implants may also be selected to fill out a face that appears "sunken" or tired.   Preparing for surgery The surgeon will give specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications.   Liposuction is performed in a hospital and a day's stay in the hospital will be required.   Anaesthesia for liposuction Various types of anaesthesia can be used for liposuction procedures but usually unless the area to be treated is small, general anaesthesia is used. If only a small amount of fat and a limited number of body sites are involved, the patient and the surgeon will select the type of anaesthesia that provides the safest and most effective level of comfort for the surgery.   The surgery The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anaesthesia and the technique used.   There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance its outcome.   Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed, then pulled through the fat layer, breaking up the fat cells and suctioning them out.The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon's preference. If many sites are being treated, your surgeon will then move on to the next area, working to keep the incisions as inconspicuous as possible.   Technique variations The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.   Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid a mixture of intravenous salt solution, lidocaine (a local anaesthetic) and epinephrine (a drug that contracts blood vessels) -- helps the fat be removed more easily, reduces blood loss and provides anaesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.   Large volumes of fluid -- sometimes as much as three times the amount of fat to be removed -- are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as 4 to 5 hours). However, because the injected fluid contains an adequate amount of anaesthetic, additional anaesthesia may not be necessary. The name of this technique refers to the swollen and firm or "tumesced" state of the fatty tissues when they are filled with solution.   The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed.   Ultrasound-Assisted Lipoplasty (UAL) This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique.   UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.   All surgery carries some uncertainty and risk Liposuction is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is adequately trained.   However, it's important to keep in mind that even though a well-trained surgeon and a state-of-the-art facility can improve your chance of having a good result, there are no guarantees. Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations.   The combination of these factors can create greater hazards for infection; delays in healing; the formation of fat clots or blood clots, which may migrate to the lungs and cause death; excessive fluid loss, which can lead to shock or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavourable drug reactions.   In the tumescent and super-wet techniques, the anesthetic fluid that is injected may cause lidocaine toxicity (if the solution's lidocaine content is too high), or the collection of fluid in the lungs (if too much fluid is administered).   The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even "baggy", especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.   After surgery, some fluid drainage from the incisions is possible Occasionally, a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. To control swelling and to help the skin better fit its new contours, a snug elastic garment is worn over the treated area for a few weeks.   Some post-operative discomforts, like pain, burning, swelling, bleeding and temporary numbness can occur. Pain can be controlled with medications prescribed by the surgeon.   Healing is a gradual process. The patient has to start walking around as soon as possible to reduce swelling and to help prevent blood clots from forming in the legs. The stitches are removed or dissolve on their own within the first week to 10 days.   Activity that is more strenuous should be avoided for about a month as the body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more.   A noticeable difference in the shape is seen quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.   If the expectations are realistic, then the patient is usually very pleased with the results of the surgery.     Message All rights reserved 2007@ Dr. Shrirang Purohit