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Popular Cosmetic Procedures Remove Excess Fat: Lip, Abdominoplasty create smoother, better-defined profiles

Two of the more popular cosmetic surgery procedures are liposuction and abdominoplasty or “tummy tuck.”

According to the American Society of Plastic Surgeons (ASPS) (www.plasticsurgery.org), liposuction, also known as lipoplasty or simply “lipo,” slims and reshapes specific areas of the body by removing excess fat deposits. It can be used to treat stubborn fat pockets in numerous areas of the body, including the thighs, arms, neck, hips, waist, cheeks and chin.

The ASPS says abdominoplasty removes excess fat and skin and in most cases creates a smoother, firmer abdominal profile. A mini abdominoplasty addresses the lower abdomen while a full abdominoplasty makes an incision all the way to the rib cage and involves work on the entire abdominal wall.

“Neither is a procedure for weight loss,” said Dr. Dorothy Clark with Bluegrass Plastic Surgery. “Liposuction is best done on someone who is of normal weight and has fairly good skin quality and who just has localized areas of fat that they can’t get rid of through diet and exercise.”

Abdominoplasty is also best done on someone who is of reasonably normal weight and in good health. “Patients have to be healthy because it’s a pretty big operation,” said Clark, who has been in practice for 26 years. Patients sometimes confuse the procedures. “Some women come in and say, ‘I need a tummy tuck,’ when all they need is liposuction and maybe a little bit of skin tightening at the bottom,” Clark said.

The first liposuctions were performed in the early 1900s in France. But when a well-known ballerina developed gangrene after a procedure and had to have her leg amputated, the surgery was abandoned for a long period of time, resurfacing in the 1980s with vacuum aspiration. Suction-assisted liposuction is the standard method. A small cannula, attached to the vacuum device, is inserted through a small incision. The cannula breaks up the fat cells and the vacuum draws them out of the body.

“I usually suction along the hip areas,” Clark said. “Sometimes we suction the waist area to give the patient a better-defined waist.”

In some cases, liposuction is performed along with an abdominoplasty. And sometimes the tissue removed during an abdominoplasty is used for breast reconstruction in what is called a fat transfer. Although most (90 percent) of the patients undergoing these procedures are women, men generally have liposuction on their “love handles” or chins.

The length of the surgery depends on where the liposuction is done. Most patients are back in action only a few days after their liposuction, although they may be sore for a while. “It’s kind of an assault on the soft tissues,” Clark said. After a liposuction, the patient must wear a compression garment or girdle, depending on where she was suctioned, for several weeks.

“We usually see them four or five days after the surgery because there are sometimes some small sutures that need to be removed,” Clark said. “We follow them until the swelling is more or less resolved.”

The amount of fat that is removed during liposuction varies. “With the chin you can get an incredible result taking off about a tablespoon,” Clark said. “With the thighs you can get two to three liters or as much as five liters. That’s probably the most that I’m comfortable suctioning.”

Minimizing blood loss is imperative. “For a long time they didn’t know how much blood loss there was, but we have a formula now,” Clark said. “And there are several formulas for replacing the fluid that is lost and making sure the patient is stable before you let them go home.”

By Tanya J. Tyler, Associate Editor / Staff Writer

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