Liposuction : Trunk, Thighs, Arms, Face and Neck The common perception of beauty has undergone a gradual but dramatic change over the past 30 years. The emphasis placed by modern society on a lean, youthful appearance is largely responsible for the increase demand for surgical procedures to re-contour the trunk and legs by removing excess deposits of fat. The patterns of fat accumulation vary between men and women, with women typically accumulating fat in the lower trunk, hips, upper thighs, and buttocks. In contrast, men tend to accumulate fat predominantly around the flanks and abdomen. Male breast enlargement can also occur as a result of weight gain. Liposuction / Body Contouring SAL (suction assisted lipectomy), or liposuction, is a technique of fat removal through extremely small, remote incisions. Using small, blunt tipped cannulas attached to a suction apparatus, excess fatty tissue is removed without disturbing the overlying skin. Prior to performing liposuction a very dilute solution of IV fluid, local anesthetic, and epinephrine is injected into the tissue to be treated. This provides analgesia and dramatically reduces blood loss. This often referred to as a “wet” or “super wet” technique, depending on the volumes of fluid instilled. Liposuction is most effective for the treatment of localized fat deposits that are unresponsive to diet and exercise, in patients with good skin elasticity. Generalized obesity is not a good indication for liposuction and results can be disappointing. Liposuction will not correct stretch marks, excess loose skin, or weakening of abdominal wall muscles resulting from pregnancy. These problems require and open surgical procedure such as an abdominoplasty (tummy tuck) or thigh lift. Traditional liposuction is most commonly used for primary treatment of the abdomen, flanks, buttocks, and thighs. Male breast enlargement can be effectively treated in most cases with SAL or a combination of SAL and open excision. Liposuction can be used to increase the definition of the calves in some patients. Ultrasonic liposuction is a modified technique that utilizes and oscillating cannula tip to liquefy the fat, which is subsequently removed by aspiration. This technique is most effective in fibrous areas such as the breasts, back and in re-operations. To obtain the best results from your liposuction Drs. Keller, Lovett and Rothman recommend perioperative massage. One massage can be given pre-op and then following surgery a series of post-op massages is suggested usually beginning about one week after surgery. These massages are designed to decrease swelling, pain and bruising. They also smooth and soften scar tissue helping you heal faster and lead to your desired result. Ultrasound Vitamin C treatments may also be beneficial in combination with massage therapy. Your physician will tell you when this is necessary. The cost of your first post-op massage is included in the price of your surgery. You are encouraged to consult with your massage therapist about scheduling further treatments to assist in your recovery. Liposuction Upper Extremity Recently there has been increasing interest in using liposuction to re-contour the upper arm. This is an excellent alternative to a brachioplasty (open excision of excess skin and fat) for patients who do not have excessive amounts of loose skin. Traditional brachioplasty procedures leave large scars, whereas liposuction leaves almost no scar. The face and neck are other areas receiving great interest currently. The most commonly treated area is the anterior neck beneath the chin. Marked improvement in the definition of the jaw line and the angle between the chin and neck can be achieved. Liposuction Face This procedure is normally done in the office on an outpatient basis. A compression garment must be worn for 2 to 4 weeks following the operation to help reshape the skin. Most patients can return to work within one week, but not strenuous activity is permitted for four weeks. Post-operative pain is moderate for three to five days, but easily controlled with oral pain medication.