Lıposuctıon

Liposuction is the process of removal performed through thin cannulas which create small pores on the body to suck out the excess fat. First, the body is swelled through a type of liquid and then this liquid together with the fat is removed.

In some cases, such as having a bumpy look and asymmetrical deformities cannot be corrected via removing fat, but injecting fat to the problematic area. In this case, while fat is removed from a place, this removed fat can be injected to the deficient areas after being harvested and filtered. For this reason, it would be more appropriate to use the term liposculpting (body shaping) for combination of fat removal (liposuction) and helping body contour defortmities by fat injection if necessary. The purpose of these procedure is not to help the patient to lose weight but to shape their bodies.

Fat tissues consist of fat cells and there are a number of genetically encoded fat cells in our body. After puberty, no new fat cells are formed in the body. As one gains and lose weight, the existing fat cells grow and shrink. For this reason, after the surgery, if the patient does continue a healthy lifestyle, although no new fat cells are formed, the remaining fat cells might get bigger. However, of course these fat cells will never become as big as they were before the operation.

Although there are individual differences, fat is often accumulated on the hips, legs and abdomen in women, and in the belly area and waist in men. In addition, intra-abdominal fat is also common in men.

Body shaping techniques are always limited to the tissue between the skin and muscles. Therefore, this type of fat can be removed only via dieting and exercise. Intra-abdominal fat is especially important when it comes to heart diseases and it is important to have a healthy lifestyle.

The success of liposculpting process depends on skin elasticity&quality. In order for the skin to recover itself when the underlying fat tissue is removed, its elasticity must be good. Patients who have gained and lost a lot of weight frequently, who have ‘cottage cheese’ look and lumpy skin would probably have poor skin quality and this problem cannot be corrected liposculpting. Likewise, in women who have given birth more than once, due to the deformity of the anterior abdominal wall muscles and loose form of the skin, satisfactory results can probably only be obtained with abdominal tightening(tummy tuck) for these patients. The ideal liposculpting patients should young patients with good skin quality and no excess weight. Liposculpting can also be performed on overweight patients, but the aim should not be to help the patient lose weight, but to provide a shape shift on the body at the weight. Since the risk of complications will increase especially for patients with a body mass index above 28, the patient is asked to lose some weight prior to surgery, and then liposculpting or abdominoplasty operations are planned. The ideal patient should have a normal weight with some fat accumulation in certain areas.

Fat injection can be performed on the necessary areas. Recently, reshaping is performed to the hips or buttocks, which create a lifted look for the buttocks. Also, fat injection can be performed to correct leg shape deformities, thickening the leg, and sometimes for augmentating the breasts.

Since the aim is not to lose weight of the patient, it is not an operation that aims to remove many liters of fat. Depending on the number of fat removal areas and the patient’s anatomy, usually 2-4 liters of fat is removed. Up to 10% of the patient’s weight is considered to be within the safety limits. Personally, I rarely apply more than 5 liters of liposuction in one session in order to minimize the risk of complications.

Before the operation, the areas with regional fat are determined and how much fat will be taken from and where to be given if necessary is planned with the drawing. Anesthetic and anti-bleeding drugs are given to the areas where fat will be removed. Subsequently, incisions are made in sizes where thin cannulas enter the body to suck out the fat, these incisions are approximately 0.5 cm. long and located in the least visible parts on the body. After that, the fat is sucked by creating negative pressure with vacuum injector or motor. If fat injection is planned, absorbed fat is collected in a sterile environment, filtered, and transferred to the planned areas.

Because the success of liposculpting depends primarily on skin quality, it gives better results in young or middle-aged patients. However, it can be applied to active, non-smoking, advanced elderly patients with good skin quality as well.

The type of anesthesia also varies according to the amount of fat to be removed. It is performed under local anesthesia and sedatives (sedation) if it is to be performed in a small limited area, otherwise, it should be performed under .

The operation time varies according to the amount of fat to be removed and the area to be operated. While a longitudinal procedure may take half an hour, a detailed liposculpting on multiple areas can take up to 5 hours. However, energy-based liposuction devices, which have been used widely in recent years, also shorten the operation time.

Although it varies according to the area where it is performed, patients mostly complain of a deep pain in the waist and back region. However, this pain is easily controlled with pain management and medications recommended by your doctor. After the first few days, it becomes very light, usually at the end of the 1st week, which will not disturb the patient.

Patients can be discharged after 6 hours after liposculpture is applied to restricted areas. However, I find it more convenient for patients who undergo extensive liposculpture to stay in the hospital for 1 night in terms of pain management and acute stage of the healing process. Small waterproof dressings are applied to liposculpting incisions. It is normal for a bloody fluid to leak from these holes in the first 24 hours. If a large amount of fat has been removed in large areas, drains can be used, which would be removed on the next day. The next day, the patient is prescribed medications and sent home with instructions. You can take a shower two days post surgery. After three days, the patient is expected to come for post operative check ups and the pain has decreased since the day of the surgery. I do not recommend any sport activities other than walking for the first three weeks. After 6 weeks, all kinds of sports can be done. Two weeks after the operation, lymph drainage massage is recommended to the patients in order to accelerate skin tightening and reduce edema. In the first three weeks, swelling and bruises occur in the liposuction areas. After the third week, edema dissolves, the skin becomes less stiff and curvier. The final form is seen only after 3-6 months. There may be a decrease in skin sensation in the first weeks in the treated areas.

If patients who undergo extensive liposculpting do not make changes in their lifestyle and diet after surgery, fat accumulation becomes more intense in different parts of their bodies when they gain weight. For this reason, patients should be explained in detail that they will need to pay attention to their weight after the surgery. After an extensive liposculpting surgery, patients have to pay more attention to keeping an active lifestyle and eating healthy.

It is very important for the patients to wear a corset continuously for the first 3 weeks. Of course, after the first few days, patients can remove the corset for a short time while taking a shower.

We want the patients to move and drink plenty of water in the early healing period so that the postoperative edema can dissolve faster. It is important to use moisturizers in terms of increasing the skin quality of the skin for the operated areas. Two weeks after the procedure, the patients can begin endormological treatments to help tightening the skin. Although these do not affect the final result, they accelerate healing. Some of these treatments are called lymph drainage massage, radiofrequency and LPG applications. And most importantly, we recommend that patients pay attention to eating healthy and keeping an actibe lifestyle.

Although the life-threatening complications due to fat embolism after liposculpting have recently made liposculpting a scary procedure due to exaggerated applications that exceed the safe limit, I think this procedure is quite safe when it is applied to the correct patient under the saferty limits. Surgery risks include bleeding, infection, organ injuries, fat and pulmonary embolism. The most common problems we see, are body definition deformities, irregularities, dents and skin pigmentation issues on the skin. These are generally problems due to insufficient skin quality or excessive fat removal through incorrect application. If these occur, the deformity can tried to be corrected with a technique called liposhifting or fat injection.

Just like in conventional liposuction technique, it is the process of breaking the fat with laser by inserting cannulas through small pores of the body. Fats are first disrupted by laser and then removed via a vacuum system with cannulas. In laser lipolysis, fat is broken down in limited areas but not removed, left to be absorbed from the body. The advantage of laser-assisted liposuction is to reduce bleeding during the procedure, increase and accelerate the tightening of the skin. However, its superiority in the long term is vaguse and the biggest complicateion could be the burns on the skin due to use of cannula.

It allows a more homogeneous and bleeding-free liposuction process by separating fat from other tissues with the help of mechanical microtiter cannulas.

It provides a less traumatic experience with less bleeding by separating and emulsifying fat from other body parts such as vessels and nerves with vibrations. However, as it allows for a more homogeneous fat removal, postoperative skin fluctuation and collapse risks are reduced. Patients have advantages such as less postoperative pain and bruising compared to classical liposuction. As, it will shorten the operation time, it is a less tiring for the surgeon as well.