Liposuction is a highly effective surgical intervention designed to treat superficial and deep deposits of subcutaneous fat distributed in aesthetically unpleasing proportions, thereby improving body contour.
Although liposuction was originally intended to treat minor contour irregularities, advances in liposuction surgical techniques and a better understanding of the physiologic consequences of liposuction have enabled recontouring of large regions and multiple body areas. These advances have changed the nature of liposuction, taking it from the realm of a minor surgical procedure to that of major surgery.
Over the past 35 years, liposuction has proven to be a safe, effective, and popular intervention for the surgical removal of adipose tissue. Liposuction techniques have advanced from the treatment of minor contour irregularities to more extensive body contouring. Liposuction patients should be assessed like any other surgical patient. This includes a complete preoperative evaluation, with particular attention to anything that might predispose the patient to complications.
The surgeon can now choose between a variety of liposuction techniques, cannula designs, and anesthesia options. When selecting the most appropriate techniques for each individual patient, the surgeon must consider several factors, including the anticipated liposuction volume, the number of unrelated procedures, the treatment sites, the anesthesia route, the facility type, and the patient’s overall health status.
Appropriate postoperative management of the liposuction patient is critical for achieving the best possible outcomes. To this end, a qualified staff is essential for providing the appropriate postanesthesia and postoperative care. Managing the fluid and electrolyte balance, treating pain, and monitoring for complications are important duties, particularly in large-volume cases.
When performed by a surgeon with knowledge of the physiologic implications of this surgery, liposuction can be a safe procedure that results in significant patient satisfaction.
One of the most important aspects in the success of any surgical procedure is the physical condition of the patient at the time of surgery.
As has been shown previously, patients who embrace diet, exercise, and a healthy lifestyle are much more likely to lose weight, be satisfied with results, have higher self-esteem, and have increased productivity
A detailed physical exam is performed at the first visit.
Specific attention to prior scars, presence or absence of hernias, evidence of venous insufficiency, and presence of preexisting asymmetry or contour irregularity should be discussed and noted in the chart.
At the initial and subsequent visits, height and weight with calculation of body mass index (BMI) is paramount for safety, as well as for observation of long-term trends during follow-up.
For liposuction candidates, six key elements should be documented:
1. Evaluation of areas of lipodystrophy and contour deformities
2. Skin tone and quality
3. Asymmetries
4. Dimpling and cellulite
5. Myofascial support (A thorough evaluation for hernias should be performed; of particular concern are larger patients with prior abdominal incisions. These patients may require computed tomography [CT] scanning to confirm the presence or absence of an occult
Hernia)
6. Zones of adherence
The exam is best performed in front of a mirror. This allows an open dialogue between patient and physician, wherein the patient’s concerns can be addressed and previously unrecognized problem areas can be assessed.
Any areas of cellulite should be pointed out to the patient, and a specific discussion of expected outcome in these areas should be noted. At the initial evaluation, high-quality medical images should be obtained, with anterior, posterior, lateral, and oblique views. This will allow for documentation of results, as well as objective evaluation of outcomes by both patient and physician.
Liposuction surgery usually improves contours. In some instances it may be used in a circumferential fashion, thinning an area. Since the healing process is gradual, you should expect to wait at least several months to get an accurate picture of the results of your surgery. The small incisions used for access of the instrument known as a cannula, will fade over a number of months usually becoming barely visible.
The results of liposuction surgery are usually long lasting, but they may be affected by weight gain, aging, pregnancy and lifestyle factors.
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. Pictures may be taken of you especially if the areas that will be treated are on your posterior aspect (back, buttock, etc.). This will help Dr. Hakan Gundogan to understand your expectations and determine whether they can realistically be achieved. A determination of the elasticity of the skin will also occur.
A discussion concerning your ideal weight and realistic weight will most likely occur. Plans such as future pregnancies, etc. may be discussed.
You should come to the consultation prepared to discuss your medical history including previous surgeries, past and present medical conditions, allergies and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems, diabetes, etc. should be reviewed as these medical conditions may increase some risks associated with surgery.
The basic technique of liposuction involves the removal of fat via a hollow metal tube (cannula) that is passed through the fatty tissue. One of the most common types of liposuction involves the aspiration of fat by attaching a pump that generates a vacuum. This is known as suction assisted liposuction (SAL). In addition, a motor may be used on the cannula that causes the cannula to vacillate back and forth thus performing much of the “work” of liposuction know as power assisted liposuction (PAL). An ultrasonic generator may produce sound waves above audible frequency that “breaks” the fat cells and the broken down fat is removed by SAL. A laser can also be employed to break down the fat cells. Each of the methods has advantages and disadvantages. These methods will be discussed with you at the time of the consultation. Additionally, the above techniques may be combined to yield optimal results. The decisions concerning the appropriate technique will best be accomplished by Dr. Hakan Gundogan.
The goal of Dr. Hakan Gundogan and the entire staff is to make your surgical experience as easy and comfortable for you as possible.
If you are a smoker, it is recommended to stop smoking well in advance of surgery since smoking can impair the healing process. Certain medications that increase the risk of bleeding such as Aspirin, non-steroidal anti-inflammatory medications, and some vitamins/homeopathic regimens should be discontinued before undergoing liposuction surgery. Dr. Hakan Gundogan will provide you with additional preoperative instructions.
Liposuction surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for the next 24 hours. If you are undergoing large volume of liposuction, it may be suggested that you be hospitalized even for one night.
Your liposuction surgery will be performed in an accredited hospital.
Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing liposuction surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will most likely be wearing a compression garment, usually used to help “shrink” the skin. Concerning postoperative pain, many patients state that the area feels sore, as if they underwent a vigorous work out.
You probably will be permitted to go home after a short period of observation, although some patients may stay overnight in the hospital or surgical facility.
It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first few days after surgery, you should rest quietly. If you can elevate the body part, it is usually suggested that you do so. Remember, you must not take aspirin or certain anti-inflammatory medications. You most likely will wear a garment. If it is too tight you should promptly notify Dr. Hakan Gundogan.
During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. The swelling persists longer. Bruising typically disappears within seven to ten days. Stitches are usually removed within a week of surgery.
Straining, bending over and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within ten days or less.
You will return to Dr. Hakan Gundogan's office for follow-up care at prescribed intervals, at which time your progress would be evaluated as a result of your liposuction surgery.
Please remember that the relationship with Dr. Hakan Gundogan does not end when you leave the operating room. If you have questions or concerns during your recovery from liposuction surgery, or need additional information at a later time, you should contact Dr. Hakan Gundogan.
