You may be a candidate for liposuction if you have excess subcutaneous fat, which is resistant to diet and exercise. Liposuction may also be desirable if you wish to change the contours of your body. Commonly involved areas are the anterior part of the neck (under the chin), upper arms and armpits, male chest/breasts, trunk, abdomen, waist, hips, thighs, inner knees, calves, and ankles. Most patients are near normal weight and desire permanent contour changes.
Liposuction FAQ
Liposuction patient shown before surgery with
bulging hips, thighs and buttocks.
Improved techniques now allow larger amounts of fat removal. Liposculpture can be useful to heavier persons as well.
Liposuction is intended to produce a permanent improvement in the contour and proportion of the treated areas. A more flattering figure or physique, in or out of clothing, is another goal of liposculpture.
Short incisions are made through the skin to introduce the instrument
that will remove fat in the shaded areas. A similar technique may be
used to remove localized fat deposits from other areas of the body.
Liposuction is done on an outpatient basis. General anesthesia is usually used for safety and comfort. Small suction tubes (cannulas) are inserted through very short incisions placed in inconspicuous locations near the fat deposits, and excess fat is removed. If large volumes of fat are to be removed, we will probably ask you to donate one or two units of blood and take supplemental iron before surgery. Your own blood will be used as a transfusion at the end of surgery.
A long, hollow tube with an opening at one end is inserted. At the
tube’s opposite end, a vacuum pressure unit suctions off fat. Ultrasonic
energy sometimes may be used to liquefy fat before it is removed.
The patient goes home with a compression garment (or tape) covering the treated areas. Compression is advised for about a month as it helps reduce swelling after liposuction. Once pain and soreness decrease, it is frequently more comfortable to wear lycra or spandex exercise pants. Initial discomfort is easily controlled with oral medication. Bruising and swelling usually subside in 2-4 weeks. The final result takes shape over 2-3 months.
The postoperative patient with slimmed lower body contour.
Additional procedures that may enhance the result of liposuction are Tummy Tuck (Abdominoplasty), Breast Reduction, Thigh Lift, or Buttock Lift.
Liposuction is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment
The specific risks and the suitability of liposuction for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.
Illustrations courtesy the American Society for Aesthetic Plastic Surgery.
Liposuction FAQ
Q: Who is a candidate for liposuction?
A: The ideal liposuction patient has localized areas of excess fat; a bulge; or a disproportion. It is not for the overweight whose fat is evenly distributed. Overlying skin should be of good quality since it must contract over the thinned body. Patients need to be healthy enough to undergo elective surgery.
Q: What is liposuction?
A: A small tube called a cannula is placed through a very small incision into the fatty layer of tissue under the skin. The cannula is connected to a vacuum and fat is removed.
Q: What are the most important factors to consider when deciding whether or not to get liposuction?
A: There is this notion in our society today that it is always better to be thinner. That is a flawed concept. What is best is to have a beautiful shape, and that often means having some degree of curves. So often people look to liposuction as an excuse for poor eating habits. The important factors to consider are whether you realistically can change your weight, and if not, the extent to which your overall shape would benefit from having an improved contour.
Q: What type of liposuction gives the best results:
A: The media focuses on technology over technique. Companies that make various liposuction devices and machines spend a lot of money trying to get you to ask for their product. And the doctors who buy these machines will sometimes do so for the sake of marketing. But here's the secret: great liposuction is done by great surgeons. It is definitely the carpenter that makes the difference, not the tool.
Q: How is a great liposuction result achieved:
A: From a technical point of view it is about a surgeon having a great eye and ability to see in three dimensions. Technical expertise is required in order to remove fat so that a smooth contour remains. But the most important factors are not technical: it is deciding what will look best cosmetically, and determining how much of a fat removal the skin will allow. On its simplest level, people want to look thinner and liposuction makes patients thinner. While thin is a goal, it should not be the only goal; in fact looking attractive with a beautiful contour is even more important. So deciding how much to remove where is very important. It is like the old joke about the sculptor is asked how he can sculpt an elephant from a piece of marble. And the sculpture says that all you need to do is remove what is not an elephant! So the key in liposuction is planning what really should be removed. But even if a lot would ideally be removed, this can only be done if the skin overlying those areas is of sufficient quality to contract back after the fat is removed. Though some patients would rather be skinnier even if it means looser skin, some do not. Anticipating how the skin will retighten is an imprecise process, but it must be done and discussed with the patient in order to plan the surgery.
Q: What areas of my body can I have liposuction on?
A: Almost any area of the body with excess fat can have liposuction. The most popular areas are under the chin (submental area), the arms, the chest, the back, the love handles, the stomach, the inner thigh, outer thigh, knees, and calves/ankles.
Q: Are there any areas that are particularly well suited for liposuction?
A: The hip rolls or love handles are usually the best area. The skin usually contracts very well here, and there is not a tendency to develop dimpling or cellulite. Patients will more frequently complain about their stomach than this area, but it is surprising how much fat is stored in the hips, and liposuction of the hips can therefore yield a big improvement in contour. But usually any area with good, tight skin that looks relatively full does well.
Q: Are there any areas of the body that are not good for liposuction?
A: When the thin is thin or crepey, it is not likely to tighten over the area that has undergone liposuction. If a part of the body is already a little deflated looking, then that is a sign that the skin has not been able to tighten over that area. Removing more skin risks worsening that. Though some companies and some surgeons claim that they can tighten skin, none of these claims has been validated, and no one should undergo liposuction with the expectation that their skin will be tightened. In particular, one should realize that the stomach and inner thighs are two areas in which - generally speaking - the skin has less of an ability to tighten and perhaps more of an ability to develop cellulite. They are still potentially good areas for liposuction, but not to the extent that the hip roll is.
Q: What is your artistic approach to assessing an area for liposuction?
A: I first assess whether the fat in that area is disproportionate to the rest of the body or creates some kind of a contour irregularity. It does not make sense to take a proportional - albeit overweight - body and treat just several areas, as that makes the body disproportionate. If a patient asks to treat a lot of areas, that means that the patient is simply overweight, and liposuction is not a treatment for being overweight. When there is less fat and the skin quality is good, the better the result will be. When there is more fat and the skin is not very good, particularly if the area already looks a little empty, the less ideal that location is for liposuction.
Q: Describe your approach to these specific areas:
Arm: Many women are very displeased with excess fat in their arms. There is a tendency just to look at the back of their arms, or the part that hangs down when their arms are held straight out to the sides. But it is also important to look at the bulge to the sides of the arms that are noted when the arms are kept straight down at their sides. This can give the appearance of greater width to the body, and treating this is part of creating an aesthetic arm. The position and size of the deltoid, triceps, and biceps all are important to take into account so that the muscle is exposed just the right amount. But many women with sun-damaged, thin, and even loose skin ask to have liposuction of their arms. Some of these women will need an "arm lift" procedure in order to remove the lax skin. This involves significant scarring, and unless the problem is very severe many women would not want to do this. It is just important to know that the arms are an area in which there is a tendency to develop lax skin, and when this happens liposuction alone is often not a satisfactory treatment.
Male chest: Treatment of male breasts - gynecomastia - is the fastest growing plastic surgery procedure in the UK as well as the USA. It is so common and I see so many such patients that I have developed a website specifically for it, http://www.beverlyhillsgynecomastia.com/ . Two types of tissue make up gynecomastia: fatty tissue and glandular tissue. The glandular tissue is firm and rubbery. It cannot be removed with liposuction, but rather needs to be excised. Fatty tissue can be removed with liposuction. In some cases liposuction alone is the ideal treatment for gynecomastia, in others excision of glandular tissue alone. And in many both methods are necessary.
Female breast: The so-called "scarless breast reduction" is breast reduction by liposuction (see breast reduction FAQ's.) With just two small incisions under the breasts, fat can be removed from the breasts and the breasts made smaller and lighter. It does not lift the breasts and the amount of weight removed is limited by how much of the breast is made up of fat as opposed to glandular tissue.
Upper Outer breast: Many women complain of a little bulge of fat just in front of the top of their armpit which creates a bulge just to the side of the bra. In severe cases this is due to an abnormal build up of glandular breast tissue. But when it is just fat, the area can be reduced with liposuction. This is frequently done at the time of a breast augmentation.
Tummy: The tummy is one of the most frequently requested areas for liposuction. It is also one of the areas that most frequently has contour irregularities following liposuction. That is because there is usually less fat here than most people imagine. For most their love handles/hip rolls contribute much more to their girth than excess fat on the stomach. Stomach skin also doesn't have the same capacity to snap back and maintain elasticity of many other parts of the body. After weight loss or pregnancy, this skin can be a bit loose, creating the impression of more excess fat than there really is. And this skin often develops a little bit of cellulite in the best of cases, and there is a risk that this can be worsened with liposuction of the stomach. But when the fat layer is thick and the skin quality is good, liposuction of the abdomen can yield a tremendous improvement.
Upper back: Many patients with liposuction of too many other parts of the body come in requesting liposuction of over and around their shoulder blades. That is probably because if many other fat stores are removed, the untouched fat cells in this area can swell. But many others who have not had liposuction done elsewhere can still have excess fat here. The skin quality is usually excellent and contracts well. But the fat is very fibrous and it is difficult to get as much fat out as many patients wish could be removed.
Love handles/hip rolls: Unquestionably this is the best area for liposuction. A lot of fat can be hidden here, the skin quality is good, and usually a lot can be remove with no change in the quality of the skin. Reshaping this area can make a big difference in someone's overall contour, making the buttock look better and the entire body look much smaller.
Buttock: Liposuction of the buttocks is uncommonly done because the buttock skin does not contract well and often looks droopy. This is only done in limited amounts in someone whose buttocks clearly has an overly-inflated look.
Outer thighs: Outer thighs are an important area for liposuction. Many very thin women have excess fat in this area that creates a disproportionate shape. The key to this area is deciding how much should be removed because it is easy to have too much removed, which makes the area look flat and androgenous. It is very important that it is done technically very sound, as dimpling and surface irregularities are possible.
Inner thighs: If someone has a bulge high up on the inner thighs, it can be reduced well with liposuction. But if someone does not have a bulge, but is just full from the top of the thigh to the knee in one straight line, it is impossible to do liposuction to thin the entire area out uniformly and evenly. It is particularly important to assess the skin quality of the upper inner thigh as well. That skin can get thin and dimpled in some patients, and if it is lax enough, a thigh lift may be necessary. It is important to recognize that only in extreme cases is liposuction of the inner thighs visible to people other than you. Indeed, it is hard to demonstrate even a significant three-dimensional improvement in the inner thighs on a regular two dimensional photograph. What is best about inner thigh liposuction is that you will not feel your thighs touching as much, and by reducing the thickness of your thighs, pants will fit looser on the outer thighs and generally allow pants to fall better on you.
Knees: Many women have a bulge in their inner knee. If this bulge is reduced even a little bit, the leg can look much longer and more slender. Sometimes a bulge just above the knee can also be removed by liposuction. But if the skin above the knee is thin and crepey, then liposuction above the knee is not a good idea because the small gain in fat reduction by working on that area is often offset by the increase in wrinkling of the skin.
Calves/ankles: Liposuction of the calves and ankles can give some of the best results in liposuction, but the recovery is longer and the swelling takes more time to resolve than most other areas of liposuction. Most people realize how much swelling can occur in the feet and ankles after a long day at work or even an airplane flight. For those same reasons, swelling in this area persists for months after calf/ankle liposuction. But for patients willing to wear compressive stockings for months after surgery the results can be dramatic. Patients who were unable to wear boots before can find themselves able to wear boots, or feel much more confident wearing shorts or a skirt.
Face: Liposuction of the face was a procedure that was touted about twenty years ago. But it is largely abandoned now because we now realize that the body tends to loose facial fat with age. So though it can make someone look thinner, they often look older. And it is nearly impossible to do liposuction smoothly enough on the face so that no irregularity is visible.
Q: Is there a problem with removing as much fat as possible?
A: When more than 5 liters is removed, there is an increased risk of blood clots and other disorders, and patients need to stay at a recovery center. But the point to recognize is that liposuction is not a remedy for obesity; it is a fat contour procedure which is not a substitute for weight loss.
Q: Do you have to be thin to have liposuction?
A: Liposuction is not necessary for thin; liposuction is not necessarily not or the overweight. It is for the treatment of disproportionate areas, or areas which give a disharmonious appearance. For instance a woman with who would wear a size 14 top and size 18 pants might be a good liposuction candidate.
Q: Will the fat come back elsewhere?
A: The calories you eat but don't burn will get stored as fat. Since the areas treated will have fewer fat cells, the treated areas will be less prone to regain fat if you eat too much. So other areas could get disproportionately larger, but the fat isn't really going somewhere else as much is it is that new calories are being stored in a different balance.
Q: Can you do liposuction over my whole body?
A: Some people jokingly ask for "head to toe" liposuction. But liposuction is not for people who need to lose weight everywhere and whose fat is well-distributed. From a strictly technical point of view, liposuction treats distinct areas, and cannot be done over the entire body.
Q: Are you aggressive with liposuction?
A: Aggressive liposuction leads to contour irregularities, asymmetries, and a non-feminine figure. It is clear that women want to be thin, but they should not lose femininity and take on the body of a boy in order to look thinner. Aggressive liposuction is never a good idea; safe, prudent, and with a sense of proportion and balance is the way liposuction should be done.
Q: Will liposuction make me look younger?
A: Liposuction makes you thinner, but it doesn't always make you look younger. Children are often pudgy. The more stuffed an area is the tighter and younger the skin looks. So liposuction is really a procedure to change contour. By removing fat the body does not fundamentally look younger. In cases where the skin is lax, removing more fat can make the body look more lax and even older.
Q: What is the difference between ultrasonic, power assisted and tumescent liposuction?
A: Ultrasonic liposuction transmits energy through a special handpiece that helps to melt fat, enabling a greater volume of fat to be removed. This is particularly helpful in men, revision liposuction, and areas in which the fat is dense. But it demands a slightly larger incision. Power assisted liposuction uses an oscillating handpiece which helps the surgeon to control and sculpt an area with more finesse. Tumescent liposuction refers not to a surgical technique, but to an anesthesia technique. Large quantities of a dilute pain medication are placed until the tissue is "tumesced." Most surgeons today "tumesce" the area whether or not anesthesia will be used because it reduces post surgical pain and bleeding.
Q: Isn't tumescent liposuction best?
A: There is a lot on the internet touting tumescent liposuction as the best. Almost invariably such information comes from non-surgeons dabbling in liposuction. They do not have access to operating rooms, and tumescent anesthesia is a way for them to be able to do liposuction in an exam room. That it is not to say that it is not sometimes the method of choice. It is only sometimes, but not always the best method. But be cautious of information promoting tumescent liposuction that comes from non-surgeons.
Q: What is the one best way of doing liposucton?
A: There is not a single best way. It depends on how much fat there is, how dense the fat is, what the overlying ski is like, and a number of patient choice issues. Any physician who tells you that one method is always the best is almost certainly attempting to over promote the one technique with which they have access.
Q: What kind of board certification do you need in order to do liposuction?
A: It is shocking but true that when states give medical licenses they do not restrict the physician to practice in the area in which they were trained. There is nothing that keeps a dermatologist, pediatrician, or emergency room doctor from performing liposuction or other surgical procedures. It is important to be sure that your surgeon is a plastic surgeon who is certified by the American Board of Plastic Surgery, the only organization recognized to credential plastic surgeons. They should also be members in good standing of the American Society of Aesthetic Plastic Surgery, which is at www.surgery.org.
Q: Which method gives the best result?
A: The method is less important than the skill of the surgeon performing the procedure. Do not pick your surgeon on the basis of what technique they use; select your surgeon based upon the results they get. The better surgeon will always get better results regardless of technique.
Q: What is the difference between liposuction and liposculpture?
A: They are the same thing. Some people use the term liposculpture just because it sounds more artistic.
Q: How will you determine what is the best form of liposuction for my body?
A: Dr. Teitelbaum has access to all the major types of liposuction - general and tumescent anesthesia, syringe, standard, power, and ultrasonic liposuction. He will listen to your goals, assess your tissues, and advise you as to which methods will best help me to get you the result you want.
Q: What is SmartLipo and can it be done in lieu of liposuction?
A: So-called "smart lipo" is just liposuction with a laser attached. It is liposuction, and it is surgical.
Q: Why is SmartLipo™ so popular?
A: Everyone is fascinated with anything involving a laser, and the name smartlipo™ was a brilliant marketing idea.
Q: Isn't SmartLipo™ less invasive?
A: Despite their claims, it is more invasive because it still requires going under the skin, and adds the risks and invasiveness of introducing a hot and potentially damaging laser into your body.
Q: Doesn't SmartLipo™ only use local anesthesia?
A: It can use local anesthesia, but it is no better suited for local anesthesia than any other form of liposuction. Their marketing materials focus on local anesthesia, but that is just because the company targeted non-surgeons in their promotions who do not have access to operating rooms. But all types of liposuction can be done with local anesthesia, if that is the choice of the patient and surgeon. But it is always better to have an option with anesthesia.
Q: Does SmartLipo™ tighten skin?
A: There is a claim that it tightens skin, but this has not been demonstrated clinically. Heat does tighten collagen, but the margin between tightening collagen and burning skin is very thin. Anything that actually would contract skin would flirt with burning at the same time.
Q: Doesn't SmartLipo™ hurt less?
A: Based upon the many patients I have seen who have had this procedure, they have a lot of pain, more than with regular liposuction.
Q: Is SmartLipo™ a gimmick?
A: SmartLipo™ has been discussed at plastic surgery meetings since it was introduced. Time and time again experts giving lectures conclude that the only advantage of it for a plastic surgeon is a marketing advantage. It is considered to be a gimmick because while it has a fancy name and captivating technology, it does not actual offer an improved result.
Q: Are there complications from SmartLipo™?
A: Many patients are being seen with areas of too much fat removal and uncorrectable contour irregularities. Worse, burns from the laser have been reported which can result in substantial permanent scarring.
Q: What is mesotherapy and can it be done in lieu of liposuction?
A: Mesotherapy is a series of injections of a fluid that is purported to reduce fat. Sometimes it works, and sometimes it causes horrible complications. The problem is that it comes from overseas, and the manufacturers do not disclose what is inside. And none are FDA approved; in fact it is likely a violation of law for any doctor to do it. Given the high rate of complications with the unregulated formulas that make up mesotherapy, it is unwise to leave the country to seek these treatments. But Dr. Teitelbaum was involved as a clinical investigator in a new injectable product that does reduce fat, currently called ATX-101. It uses a synthetic phosphatidylcholine, which is the chemical in bile that dissolves fat. But this product is going through a complete series of clinical trials, and is still years away from possible FDA approval.
Q: What is Endermologie and can it be done in lieu of liposuction?
A: Endermologie is a machine that sucks and vibrates skin, sort of like a massage-by-machine. It was popular about ten years ago as a means to reduce cellulite and to reduce swelling after liposuction. Benefits were small, and only were noticed while undergoing at least weekly treatments. It is now largely abandoned.
Q: Can cellulite be treated with liposuction?
A: Liposuction removes fat. It does not smooth out surface irregularities or tighten skin laxity.
Q: What is rippling? Can it be treated?
A: Rippling is often discussed as a risk of liposuction. To get a great liposuction result, two things must happen: the surgeon removes a uniform layer of fat without adjacent areas of over or under-removal and the skin must contract evenly. The closer the liposuction is done to the surface of the skin and the looser the skin is the greater the chance that this will happen. It can be improved in some cases with revision liposuction and fat reinjection, but the best treatment is to avoid the problem altogether.
Q: Can loose skin be treated with liposuction?
A: There are claims that loose skin can be treated with liposuction, but these have not been documented. Even proponents admit that it requires suction along the undersurface of skin or heating the skin to a high temperature to contract it. But both of these methods risk damaging the skin themselves.
Q: What are the downsides to having liposuction?
A: That an area could look small and imbalanced if too much is removed; contour irregularities form the fat removal or healing not being smooth; loose skin from the skin not having the elasticity to nicely contract over the area of removed fat.
Q: Is liposuction an acceptable treatment for obesity?
A: Obesity is not just about appearance; it is also about health. If you are enough overweight that your doctor told you to lose weight, then you need to lose it, whether with diet and exercise or with a bariatric surgical procedure. Liposuction in such situations does not make a person healthier, and the cosmetic results are often not outstanding when patients are reexamined several years later.
Q: Are the results of liposuction permanent?
A: The fat cells that are removed are gone. Permanently. The idea is to create a better proportioned and contoured body. If you lose weight you should maintain that balance, and if you gain weight you should also maintain that balance. So while anyone can certainly gain weight and affect the outcome, liposuction results are considered to be permanent.
Q: Will I gain weight after surgery in the areas of my body that weren't liposuctioned?
A: If you eat more calories than you burn, your body will store it somewhere. Since there are proportional fewer cells in the areas that had liposuction, those areas will have less of a tendency to get larger than the untreated areas.
Q: What form of anesthesia will be used for my procedure?
A: Dr. Teitelbaum offers patients a choice between local anesthesia, local anesthesia supplemented by IV medicine by a board certified anesthesiologist, and going completely to sleep. Patients are usually given a choice. Their decision is often based upon issues such as their anxiety level, tolerance to pain, the length of the procedure, and whether the particular areas they are having treated tend to be more or less uncomfortable.
Q: Is tumescent anesthesia just as good as general anesthesia?
A: In some body parts and for some patients, tumescent anesthesia allows for an entirely painless procedure. But I often hear stories from patients about how awful the procedure was, with patients screaming or demanding the surgery be stopped. Tumescent anesthesia patients are often given medicines such as Valium that can calm them and make them forget what happened during the procedure. This is not an absolute condemnation of the procedure, but it is a too-often ignored fact that needs to be considered.
Q: Should patients stand up during surgery for the patient to assess contour?
A: Some doctors, often non-surgeons, will tout tumescent anesthesia because it allows the patient to stand during surgery, supposedly offering the ability to create a better contour. This is entirely specious since so much fluid is injected with tumescent anesthesia that the distortion of the injected fluid overshadows any potential benefit of standing. Patients have collapsed while standing, it makes it difficult to create a sterile field, some patients find it uncomfortable, and so it is a concept that is largely found to be in disfavor. Many consider this to be an excuse made by non-surgeons without access to an operating room to overly promote their only anesthetic option, tumescent anesthesia. Excellent plastic surgeons have no difficulty creating beautiful shapes with patients properly lying recumbent on an operating table.
Q: Will there be scars?
A: Liposuction incisions are each about 3/8ths of an inch long. There are usually two for each area that is treated. They are usually hidden in folds, stretch marks, moles, under clothing or within tattoos. They will be pink for about a year, and then tend to fade after that.
Q: Will I lose sensitivity in the areas that were liposuctioned?
A: There is temporary numbness overlying the treated areas, but this will go back to normal after a few months.
Q: Does insurance cover liposuction?
A: Liposuction is a cosmetic procedure. Since its purpose is to improve appearance rather than improve or restore function, liposuction is not covered by insurance.
Q: What should I bring with me the day of surgery?
A: Wear a loose top that can be unzipped or unbuttoned. Bring clothes that are loose enough so that it will be easy to get them on over your padded liposuction garments.
Q: What is the recovery like after liposuction?
A: Liposuction can require the removal of a tiny bit of fat with one incision under local anesthesia or it can be a major procedure lasting many hours. So the recovery can vary from extremely short to one that is more uncomfortable and lasting a week or two.
Q: Do I need to go to an aftercare facility after my surgery?
A: Patients having large volumes of liposuction will sometimes need to go - or at least be more comfortable - at an aftercare facility, such as Serenity which is across the street from the office. If more than five liters of fluid is removed (a very large amount) with liposuction, then California law and common sense dictate that a patient should go to an aftercare facility.
Q: Will I get a phone call from the doctor the night of my surgery?
A: Dr. Teitelbaum will phone you the night of surgery. You will also be given his private cell phone number to make it easier for you to reach him.
Q: How painful is the recovery?
A: A lot of the pain depends on the volume of liposuction being done and whether or not you needed to have an open excision. Most men describe the pain as the soreness experienced working out too hard. It responds well to pain medicine, so when you feel the pain building, take a pain pill and you will feel better.
Q: How soon can I go to work?
A: When you will feel ready to do your job is highly individualized. So long as your work doesn't involve straining and heavy lifting, you can expect to be back to work after three or four days. Some people go back even sooner, and many work from home the next day.
Q: When can I drive?
A: You can drive when you are off of all narcotic pain medication and feel totally unrestricted by your discomfort such that you could make any movement you might need to safely drive your car. That is ultimately a decision that I cannot make for you.
Q: When can I travel by airplane?
A: There is nothing about airplane travel that poses a risk to liposuction. It is just a matter of getting out of your initial, padded liposuction garments and when you will feel well enough to travel. This is usual about five days after surgery.
Q: When can I resume exercise?
A: We suggest you wait 3 weeks to be sure that everything is healed. There is always a chance of causing bleeding if you start much before that time. When you start, listen to your body. You will be a little out of condition and a bit sore. But you will get back to where you were before surgery very quickly.
Q: What is considered to be exercise?
A: Elevating your heart rate or blood pressure, bleeding hard, or straining or sweating. But light walking is beneficial starting the day of surgery.
Q: Does not being able to exercise then exclude sex?
A: Sex can be resumed as you feel comfortable. Most often patients hit their level of comfort in 3-7 days. Again, respect the fact that you have undergone surgery and try to avoid the manipulation of the incisions.
Q: When can I lift my child?
A: You can lift a cooperative child that is up to 35 pounds right away. But don't try to pick up your child if he or she is upset.
Q: When can I drink alcohol?
A: You can drink a glass of wine right after liposuction surgery. Just wait until you are done with medications and antibiotics before drinking more than that.
Q: When can I smoke cigarettes?
A: Cigarettes are not just bad for your health, but they can reduce wound healing after surgery. But of all surgeries, liposuction is the least susceptible to problems from smoking.
Q: When can I sunbathe?
A: There are no restrictions about going into the sun after liposuction.
Q: When can I shower/take a bath?
A: You can shower as soon as you are told the dressing can come off, which is typically 48 after liposuction. Wait about a week before immersing yourself in a bath.
Q: What will my post-operative appointment schedule be like?
A: You will usually be seen the day after surgery, four or five days later for suture removal, at one month, three months, and yearly thereafter. But Dr. Teitelbaum will see patients as often as they wish to be seen or have questions.
Q: How long does the swelling last?
A: Swelling increases after surgery, usually peaking about 5-6 days after surgery. After that, the swelling will subside, rapidly at first, and then gradually. After one month, you'll think the swelling is gone, but it will still go down more at three months, and even more at six months and even a year, though at that point changes are subtle.
Q: Will I have a special garment to wear after surgery? How long will I have to wear it?
A: Some plastic surgeons make patients wear them religiously for a month, and others don't require it all. That tells you that there is no absolute answer to this question. But there is no question that wearing it for the first 48 hours really reduces swelling and bruising. Therefore, leave the vest and foam on for 48-72 hours. At that point, take it off the vest and clean it. Throw away the foam padding under it and take off any band-aids. Take a shower and it is okay to take a soapy washcloth to clean your chest including the incision. After the vest is cleaned and dried, put it back on. Sometimes the vest may feel loose after being stretched and after the foam is removed. If so, let us know so that you can get a tighter vest. If it doesn't make you too warm, it is sometimes helpful to put some new clean foam on under the vest, and we will give this to you if you wish. The more you wear the vest, the faster the swelling will go away. Most guys will wear it night and day for the first week, and then just at night for the next month. Some guys wear a tee shirt under the vest, as the material of the vest doesn't feel so good against the skin.
Q: Once the swelling subsides, how much smaller will I be?
A: You will be as much smaller as the amount of fat that is removed. Some times only a little bit is removed and only you will feel or see a small difference. In other situations the change is dramatic and you need to get an entirely new wardrobe.
Q: Why do I feel larger than before?
A: In the initial weeks after surgery, the swelling can be a greater volume than the fat that was removed. Almost everyone gains some weight and feels bigger for a while. Avoiding salty foods, drinking water, and wearing a compression garment can help speed the process. But the major determinant is how much was done and your own biology. Generally, though, by a month you will not really look or feel very swollen, but substantial improvement will be made in your contour for up to a year, though there usually is not much change after three months.
Q: What do I have to do to care for the incision?
A: Liposuction incisions are very small. You do not need to do anything with them right after surgery other than to be sure that there is gauze over them to absorb any fluid that will drain. Once the sutures are removed, nothing needs to be done with the incision. Scar treatments can be used, but there is no evidence that anything will actually change the fate of a liposuction incision scar.
Q: Why do I ooze from my incision sites after liposuction?
A: That is because there is a lot of watery local anesthesia infiltrated and it takes a few days for the incision to heal up and prevent any more leakage.
Q: How much oozing is normal and how long will it last?
A: Most patients have some blood-tinged fluid leak out through their incisions for several days after surgery. It is often enough to significantly soil bed linens.
Q: When do the stitches need to be removed?
A: The liposuction sutures will come out in 4-6 days after surgery. If you had an excision from around your nipple, those stitches are absorbable.
Q: What should I do to prevent scarring?
A: Usually the liposuction scars are small and heal very well. The bottom line is that the fate of your scar is mostly determined by your own genetics and by the surgery itself. It is not clear the extent to which putting things on scars will influence their final appearance. However, most patients want to do something. There has never been a direct comparison between the various products. Patient feedback has been the most positive from three sorts of things: Scar Guard, which is a liquid containing steroid, Vitamin E, and silicone that you brush on like nail polish; Silicone gel strips (such as Neosporin scar strips); and silicone ointment (such as Scar Fade.) You can get these from the office or the pharmacy, and you can start putting them on once the glue or the steri strip is off, following the instructions on the packaging.
Q: Will lymphatic massage help my recovery?
A: Lymphatic drainage massage can help increase circulation and reduce the amount of swelling (edema.) The effect is not so profound that it is routinely recommended. But if you enjoy getting massages then this is something you should do.
Q: What do I need to watch out for?
A: Of all surgeries that plastic surgeons do, liposuction probably has the lowest incidence of postoperative emergencies such as bleeding or infection. But they still can occur. So if you develop sudden swelling or pain or drainage, you should call the plastic surgeon. In addition, if liposuction patients get too much anesthesia, they can experience symptoms from an overdose of lidocaine such as a metallic taste, restlessness, lightheadedness, and numbness around the mouth and tongue. These are medical emergencies. Patients with very large volumes of liposuction can develop life threatening blood clots, which can present as leg swelling or shortness of breast. These are also medical emergencies.
For more information about liposuction:
|
