Fat distribution is determined by two factors, heredity and diet. Heredity determines the location and number of individual fat cells, which are fixed and unchanging after puberty. Diet can increase or decrease the amount of fat in each cell but will not affect the total number of cells or their distribution. For example, if you have inherited large numbers of fat cells on your thighs and small numbers of fat cells on your chest, you will always have more fat on the thighs than on the chest, and strenuous attempts at weight loss can leave you with a thin upper body and persistently bulky thighs. At The Center for Dermatology, Cosmetic & Laser Surgery, we use liposuction to help our Westchester, NY patients get rid of areas of unwanted fat that remains in spite of diet and exercise.
To find out more about liposuction at our Mt. Kisco center, request a consultation online, or call us at (914) 241-3003.
Curious about the results you can expect? See our work for yourself with our gallery of real patient before-and-after photos.
What is Liposuction?
Liposuction is a surgical procedure for removing localized deposits of subcutaneous fat. Although the procedure was originally developed for the torso and thighs, it is now used on all areas of the body and has proved particularly helpful in contouring the area under the chin.
A 1/8 to 1/4 inch incision is made near the area from which the fat is to be removed, and a specially designed surgical cannula (tube) is placed through the incision into the fat. The cannula is attached by flexible tubing to a vacuum pump that removes the fat by suction as the cannula is manipulated beneath the skin.
Your appearance after liposuction will be influenced by your general state of health, the overall condition of your skin, age, weight, hormonal influences, and other factors. Each patient is unique, and during your consultation, details about how these general factors apply to you in particular will be discussed. Liposuction is not a substitute for a healthy diet nor is it useful for generalized weight reduction. While the foregoing may seem obvious, it is necessary to mention it because some patients may expect localized fat removal to effect a dramatic weight loss. This is not possible.
Liposuction selectively removes fat only from those areas in which the patient desires reduction. Since the actual fat cells are removed, the procedure is permanent, and following liposuction the body will always have less fat in the treated areas.
Good skin elasticity is a desirable attribute in all patients since it makes for a smooth surface contour. Tight skin is universally seen in the very young and is gradually lost as we age. Even through middle age, however, we retain some elasticity. The skin envelope always shrinks to adjust to the reduced contour following an appropriate liposuction.
The word "cellulite" has no precise medical meaning. Most people use the word to refer to dimpling and irregularities that occur on the surface of the skin. It is seen most frequently over the lower torso and thighs, worsens with age, and is frequently associated with loose skin (see below). Cellulite is due to protein degeneration in the skin and its supporting structures. While liposuction will not cure cellulite, it will remove fat and reduce contour. In mild cases liposuction may lessen the intensity of cellulite.
Permanency of Results
The number of fat cells is fixed after puberty. Adults become thinner or fatter by reducing or increasing the amount of fat in each cell. Since liposuction reduces contour by removing fat cells, the procedure is permanent. Should you gain weight following liposuction, you will tend to deposit the fat in areas other than those treated.
With tumescent liposuction, no general or systemic narcotic anesthesia is necessary. The Lidocaine is added directly to the tumescent solution, and provides complete anesthesia.
Duration of the Operation
The operation lasts 1 to 3 hours, depending on how many areas are treated.
You will be placed in a support garment immediately after surgery, and you will wear the garment continuously for 1 to 2 weeks. You may remove the garment to shower starting 24 hours after surgery.
You will be seen 1 to 3 days after surgery and 1 week, 1 month, 3 months, and 6 months after surgery. Patients may return to work the day following liposuction. Vigorous sports are prohibited for 3 weeks.
For the first week following surgery the treated areas may be swollen and may show no reduction in contour. In fact, you may appear larger than you did before surgery. Your clothes may fit more tightly, and you may weigh more. By the end of the first week, however, the swelling associated with surgery begins to subside, and sometimes during the second week you will notice a diminution in contour and the treated areas will be smaller than they were before surgery. Resolution of swelling occurs rapidly after the first week, but your final improvement may not be apparent until as long as 6 months after surgery.
Preoperative photographs will be taken. The body photographs do not show your face. They are important aids in planning and performing surgery and become a permanent part of your patient record. Postoperative photographs are taken at follow-up visits.
In the past, scars from body contouring were long and conspicuous. Liposuction scars are usually less than 1/4 inch long and can be placed in natural body creases or in other areas where they are inconspicuous or easily hidden by clothing or bathing suits. In some patients the scars may be red or pigmented for 6 months and gradually fade thereafter until they are not noticeable by 12 months after surgery. The scars are rarely troublesome. Nevertheless, you should know that all scars are permanent and their height, width, and final color are not totally predictable.
Complications and Untoward Results
Serious complications are uncommon with this kind of surgery. All patients have bruising, which lasts 2 to 4 weeks, occasionally longer. A certain amount of numbness or reduced sensation in the treated area is also to be expected. As with any surgery, bleeding, infection, and other complications are possible.
Patients may experience contour irregularities in the treated areas following surgery. Usually this is temporary, but in occasional patients, may be permanent. Perfect symmetry is the goal, although small side-to-side differences can occur. Every effort will be made to give you as smooth and symmetric a result as possible.
Five percent of patients have secondary surgery or a "touch-up"after 6 months, most frequently for removal of additional fat.
Should you not understand any of the foregoing, or should you want further information, please ask. Occasional questions will arise after you have left the office. Feel free to call for additional information. If necessary, a second visit can be scheduled. Find out all you need to know. We wish all patients to be fully informed.
Preoperative Instructions For Liposuction
- Avoid aspirin and aspirin-containing compounds and Ibuprofen (e.g. Advil, Motrin) for two weeks prior to surgeryand two weeks after surgery. Orudis and Aleve should also be avoided.
- Avoid Vitamin E as above.
- Take Vitamin K as prescribed for two weeks prior to surgery.
- Wash areas with Phisoderm or Hibiclens daily for one week prior to surgery.
- Do not drink alcohol-containing beverages for 48 hours prior to surgery.
- Shave hair if excessive in the areas of the surgery - 48 hours prior to surgery.
- Wash hair night before or morning of the surgery.
- Start antibiotic as directed day before surgery.
- Medications may be taken the morning of surgery with a light breakfast.
- Arrange for a person to drive you home from the office and also arrange for a person to stay with you over night.
On day of surgery, we recommend that you bring the following:
- Loose comfortable clothing (e.g. sweatsuit)
- Slip-on shoes (no laces or ties)
- Compression garment
- Large bath towels (4)
- Extra pair of socks
- 1 or 2 audiocassette tapes
- Something to eat and drink
- One dose of your antibiotic medication
Checklist and summary of items needed for liposuction:
- Antibiotics and Vitamin K as prescribed
- Phisoderm or Hibiclens
- Compression garment
- Bacitracin ointment
- Absorbency pads (e.g. "Dignity")
- Extra-Strength Tylenol
- Postoperative Liposuction Instructions
You will be given this form at the time of surgery
ANTIBIOTIC: A prescription for an antibiotic will be given to all patients. Please take all of them as directed.
PAIN MEDICATION: Pain is usually minimal and usually consists of soreness. It improves markedly over the first seven days. Extra Strength Tylenol is generally all that is required. If you have pain unrelieved by Tylenol, please call the office.
MEDICATIONS TO AVOID: Do not take aspirin or non-steroidal antiinflammatory medication such as Ibuprofen for two weeks postoperatively.
DIET/FLUIDS: Meals are not restricted. We prefer you stay on a low fat diet. Please drink eight 8 oz. glasses of water per day for several days postoperatively. This is important even if you are not thirsty to prevent dehydration and constipation.
REST: Try to rest for 12 to 24 hours.
FRIEND: Please have an adult stay with you the day of the surgery.
BATHING: Normal showering is permitted the day after surgery. Replace the garment immediately after bathing.You may want to wash and dry the garment at the same time that you are showering.
GARMENT: Your special garment or binder should be worn for 1-2 weeks. Please wear the garment 24 hours a day for the first week following surgery, except when it is being washed. For the next week the garment may be worn for 12-24 hours a day depending on your needs. The extent and location of your surgery will determine how long you need to wear the garment.
POSTOPERATIVE APPOINTMENTS: Please make an appointment 2-3 days postoperatively for a quick checkup, and again in 5-7 days.
SUNTAN: Please avoid tanning until bruising is gone.
DRAINAGE: Postoperative drainage occurs following surgery and can last 3-4 days. Although the fluid is red tinged, there is very little blood in it, most of it being injected local anesthetic and tissue fluid. If there is excessive bleeding or swelling or pain unrelieved by medication, please call the office immediately.
BRUISING: Mild bruising may occur for three weeks postoperatively.
NUMBNESS/SWELLING: Swelling will slowly disappear over six months.If mild numbness occurs, it will usually disappear sooner.REMEMBER - ALTHOUGH YOU LOOK BETTER IMMEDIATELY FOLLOWING REMOVAL OF THE DRESSING, IT WILL TAKE SIX MONTHS TO SEE THE FINAL RESULT.
RETURN TO WORK: Most patients can return to work within 1-2 days postoperatively.
PHYSICAL EXERCISE: Patients can return to light non-jarring exercise as soon as they feel up to it. Jarring exercise, such as tennis,aerobics, and running can be resumed in 3-4 weeks postoperatively depending on the extent and area of the surgery.
QUESTIONS: If you have any questions, please call the office.
DO NOT APPLY ICE UNDER ANY CIRCUMSTANCES.
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