Liposuction

Liposuction

What is liposuction?
Liposuction is a procedure to remove fat from underneath the skin using a small tube connected to a suction device. The tubes (cannulas) are placed under the skin using small 5 mm access skin incisions that require 1-2 stitches to close. Liposuction should NOT be regarded as a weight loss procedure but rather a contouring and shaping procedure.

Liposuction is used in conjunction with other procedures where tissue is being removed (i.e. tummy tuck, breast reduction, arm and thigh reduction etc.) or it can be used on its own when there is no excess skin to be removed. Liposuction is an excellent body contouring technique to remove distinct pockets of excess fat that have not responded to diet and exercise

Common areas for liposuction include flanks or “love handles”, abdomen, back, outer thighs, inner knee, breasts, side of the chest wall, armpit area, below the chin and arms. Because it removes the fat from below the skin, liposuction is dependent on the skin tightening/contracting post-operatively. Although the improvement in contour can offer start to be seen immediately following surgery, the process of skin tightening can take 6-12 months to see the final results. Wearing a post-operative compression garment for up to 4 weeks helps to accelerate the skin tightening process an minimize early swelling.

Pre Surgery Instructions

Before the procedure
No aspirin or blood thinning medications for two weeks prior to surgery. Fasting begins at midnight the night before surgery. Any medications that you take in the AM may be taken with a sip of water (except for blood thinning medications). If you get ill prior to surgery please notify us.

The Surgery

During the procedure
When done on its own liposuction is often performed under general anesthetic (you are asleep), though small areas of liposuction can be done under local anesthetic as well. The length of surgery is dependent on the location(s) and amount of fat removed.

After a patient is asleep under general anesthesia, a fluid solution is injected into the fatty tissues in the areas to be treated with liposuction. This fluid is normal saline (the same solution as is given in an IV), mixed with adrenaline (shrinks blood vessels and minimizes bruising and bleeding), and local anesthetic (to minimize post operative pain). This is called tumescent liposuction and makes removal of the fat much easier and more even. Liposuction then removes the majority of this fluid and the desired fatty tissue.

One or more very small incisions (3-4 mm in size) are used near the site of liposuction and are often imperceptible when they have fully healed. The compression garment is put on at the end of the procedure.

After Your Surgery

Post procedure
While In Hospital or Clinic
You will be in the recovery room anywhere from 1-3 hours where the team will ensure you are comfortable, eating and drinking, walking and able to urinate.
On discharge home
Immediately upon discharge from the recovery room, you are encouraged to rest under supervision and start a light diet as tolerated.
Day 1
You should be up and walking, drinking fluids, taking pain medication as described below only if required. Increase activity as tolerated, but there is no heavy lifting for 4 weeks. Leave the dressings alone.
What do I take for pain?
If you have pain, you are encouraged to start with:

Two Tylenol extra strength (total of 1000 mg of Tylenol) and one Advil extra strength (400 mg of Advil) to be taken at the same time as they work by different mechanisms and work very well together.

You can take the above three pills (two Tylenol extra strength and one Advil extra strength) every 8 hours around the clock for the first day or two. This is often sufficient for pain medication and can avoid the need for stronger medications such as narcotics (Percocet, Tylenol #3 etc.).

However, you will also have a prescription for a stronger pain medication that can be taken as needed if the Tylenol and Advil combination mentioned above does not suffice. This stronger pain medication may be taken on top of the above regimen. Please ensure the maximum dose of Tylenol in 24 hours does not exceed 4000 mg.

** Please be aware that with any medication and particularly Advil (a type of non-steroidal anti-inflammatory) there are risks of allergy, severe allergy, gastro-intestinal bleeding and stomach ulcers. Taking your medication with food can sometimes help with some of the stomach symptoms.

A post-operative compression garment and the underlying gauze dressings are left in place for 2-4 days. During this period of time, you may use a hand held shower or sponge bath but the dressings must stay dry.

It is very common and normal for some fluid to ooze onto the garment for the first few days. You may change the gauze or add extra gauze if needed.
First post-operative appointment
The initial dressing change is done on day 4-7 after surgery. The gauze is removed a small amount of polysporin or fucidin and gauze is used on the stitches once daily.

The compression garment/wrap is worn day and night for 4 weeks (except in the shower). You will be given two garments so that they can be alternated and washed.
Second post-operative appointment
The second appointment is close to 2 weeks after surgery and the stitches are removed. Dry gauze is no longer needed and you will start silicone gel sheeting for scar management a few days after the stitches are removed (the office will give you the silicone gel sheeting).

Post-operative swelling and bruising begins to will begin subside after 7-10 days but can take up to 3-4 weeks for the initial 70% of swelling to resolve.

As swelling can persist for 6 months, it will take that long to see the final results.

Patients usually require 1-2 days of downtime and should avoid strenuous exercise for 3-4 weeks.

The compression garment is no longer needed after 4 weeks but can be used if you like, particularly for exercise or activity.

The scars will take 12-18 months to fully mature and fade. Silicone gel sheeting is the best product to help with scar maturation and is used for 2-3 months following surgery.
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