Liposuction, or simply lipo, is a type of cosmetic surgery that removes fat from the human body in an attempt to change its shape. Evidence does not support an effect on weight beyond a couple of months and it does not appear to affect obesity related problems. In the United States it is the most commonly done cosmetic surgery.
Serious complications include deep vein thrombosis, organ perforation, bleeding, and infection. Death occurs in about one per ten thousand cases.
Areas operated on can include the abdomen, thighs, buttocks, and backs of the arms. The procedure may be performed under general, regional, or local anesthesia. It then involves using a cannula and negative pressure to suck out fat. It is believed to work best on people with a normal weight and good skin elasticity.
While the suctioned fat cells are permanently gone, after a few months overall body fat generally returned to the same level as before treatment. This is despite maintaining the previous diet and exercise regimen. While the fat returned somewhat to the treated area, most of the increased fat occurred in the abdominal area. Visceral fat - the fat surrounding the internal organs - increased, and this condition has been linked to life-shortening diseases such as diabetes, stroke, and heart attack.
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Uses
Liposuction is generally used in an attempt to change the body's shape. Weight loss from liposuction appears to be of a short term nature with little long term effect. After a few months fat typically returns and redistributes. Liposuction does not help obesity related metabolic disorders like insulin resistance.
Risks
There is a spectrum of complications that may occur due to any liposuction -- risk is increased when treated areas cover a greater percentage of the body, incisions are numerous, a large amount of tissue is removed, and concurrent surgeries are done at the same time.
Some side effects and complications include but are not limited to the following:
- Death
- Pain, which may be temporary or chronic
- Post-liposuction fat redistribution or post liposuction weight gain,
- Limited mobility
- Bruising
- Infections can become serious issues.
- Embolisms may occur when loosened fat enters the blood through blood vessels ruptured during liposuction. Pieces of fat can wind up in the lungs, or even the brain. Fat emboli may cause permanent disability or, in some cases, be fatal.
- Puncture wounds in the organs (visceral perforations) may require surgery for repair. They can also prove fatal.
- Seroma is a pooling of serum, the straw-colored liquid from your blood, in areas where tissue has been removed.
- Paresthesias (changes in sensation that may be caused by nerve compression) is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain), or numbness in the area. In some cases, these changes in sensation may be permanent.
- Swelling, in some cases, may persist for weeks or months after liposuction.
- Skin necrosis occurs when the skin above the liposuction site changes color and falls off. Large areas of skin necrosis may become infected with bacteria or microorganisms.
- Burns can occur during ultrasound-assisted liposuction if the ultrasound probe becomes hot.
- Fluid imbalance may impact you after you go home. The condition can result in serious ailments such as heart problems, excess fluid collecting in the lungs, or kidney problems.
- Toxicity from anesthesia due to the use of lidocaine, a skin-numbing drug, can cause lightheadedness, restlessness, drowsiness, a ringing in the ears, slurred speech, a metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions. Lidocaine toxicity may cause the heart to stop.
- Scars at the site of the incision are usually small and fade with time, although some may be larger or more prominent.
- Deformities, Bumpy or wavy appearances or more severe deformities may occur at the liposuction site after the procedure.
Candidacy
One might question who is a good candidate for increased visceral fat, which the procedure causes. It is not a good alternative to dieting or exercising. To be a candidate, one must usually be over 18 and in good general health, have an ongoing diet and exercise regimen, and have fatty pockets of tissue available in certain body areas. Significant disease limiting risk (e.g. diabetes, any infection, heart or circulation problems) weigh against the eligibility of a person for the procedure. In older people, the skin is usually less elastic, limiting the ability of the skin to readily tighten around the new shape. Liposuction of the abdominal fat should not be combined with simultaneous tummy tuck procedures due to higher risk of complications and mortality. Laws in Florida prevent practitioners combining liposuction of the upper abdomen and simultaneous abdominoplasty because of higher risks.
Techniques
In general, fat is removed via a cannula (a hollow tube) and aspirator (a suction device). Liposuction techniques can be categorized by the amount of fluid injection and by the mechanism in which the cannula works.
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Ultrasound-assisted liposuction
Ultrasound-assisted liposuction techniques used in the 1980s and 1990s were associated with cases of tissue damage, usually from excessive exposure to ultrasound energy. Third-generation UAL devices address this problem by using pulsed energy delivery and a specialized probe that allows physicians to safely remove excess fat. Surgeons found that in some cases, the UAL method caused skin necrosis (death) and seromas, which are pockets of a pale yellowish fluid from the body, analogous to hematomas (pockets of red blood cells).
Sutures
Doctors disagree on the issues of scarring with not suturing versus resolution of the swelling allowed by leaving the wounds open to drain fluid. Since the incisions are small, and the amount of fluid that must drain out is large, some surgeons opt to leave the incisions open, while others suture them only partially, leaving space for the fluid to drain out.
Preparation
Before receiving any of the procedures, no anticoagulants should be taken for two weeks before the surgery. If general anesthesia or sedation will be used, and the surgery will be in the morning, fasting from midnight the night before is required. If only local anesthesia will be used, fasting is not required. Smoking of tobacco must be avoided for about two months prior to surgery, as nicotine interferes with circulation and can result in loss of tissue. Bruising can be seen in people who smoke post surgery.
Usage
Removal of very large volumes of fat is a complex and potentially life-threatening procedure. The definition of "large volume liposuction" varies in the plastic surgery literature, no strict definition exists, and the term is arbitrary; every body is unique, so there is no "One Size Fits All" definition. Most often, liposuction is performed on the arms, abdomen, buttocks, and thighs in women, and the chest, abdomen, and flanks in men. Liposuction was the most common plastic surgery procedure performed in 2006 with 403,684 patients and in the year 2011 with 1,268,287 patients.
History
Relatively modern techniques for body contouring and removal of fat were first performed by a French surgeon, Charles Dujarier. A 1926 case that resulted in gangrene in the leg of a French model in a procedure performed by Dr. Dujarier set back interest in body contouring for decades.
Liposuction evolved from work in the late 1960s from surgeons in Europe using primitive curettage techniques which were largely ignored, as they achieved irregular results with significant morbidity and bleeding. The invention of modern liposuction procedure is linked to the name of two Italian gynecologists, Arpad and Giorgio Fischer, who created the blunt tunneling method in 1974. Then, liposuction first burst on the scene in a presentation by the French surgeon, Dr Yves-Gerard Illouz, in 1982.
Another French surgeon, Pierre Fournier used lidocaine as local anesthetic, modified the incision technique, and began to use compression after the operation. During the 1980s, many United States surgeons experimented with liposuction, developing some variation sedation rather than general anesthesia. Concerns over the high volume of fluid and potential toxicity of lidocaine with tumescent techniques eventually led to the concept of lower volume "super wet" tumescence.
Practitioners often report that many of the modern technologies touted to improve liposuction are simply advertising hooks.
Source of the article : Wikipedia
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