The goal of liposuction at Dr. A Jay Burns Cosmetic Surgery is to improve the body contour. Ideally there are localized deposits of fat that are isolated and suctioned to a balanced, smooth contour. There are several variations of liposuction techniques. Our Dallas, TX board-certified Plastic and Reconstructive Surgeon, Dr. Burns uses ultrasound-assisted liposuction and standard tumescent liposuction commonly to slim the abdomen, hips, thighs, upper arms, and neck.
It is important for the patients to know that liposuction is not a weight loss program and one must be careful not to over-suction any area. It is also critical to understand that liposuction will not improve cellulite and, in fact, may very well worsen cellulite appearance on the lower extremities. Liposuction will not tighten skin in any way. In fact, the skin will be somewhat loose after liposuction. If one thinks about this, it is intuitively obvious that if the skin envelope is a certain size and the volume of fat is reduced underneath that skin envelope, then there will be skin laxity. The younger the patient, the better the skin will "snap back," and the older the patient the less the skin will conform to the new shape. The goal is to do a prudent liposuction specifically targeting areas of concern without being overly aggressive to maintain contour. During your consultation with Dr. Burns, you will have a physical examination, a review of your medical history, and a discussion about your aesthetic goals. We want to help you look and feel amazing, and if liposuction is something you are considering, please call and schedule an appointment. We can help you achieve your best body.
If you have realistic expectations of what liposuction can do for your figure, you are an ideal candidate for liposuction. It is also best if you are in good health, and need help with localized fat deposits on the neck, chin, upper arms, abdominal wall, back, hips, or thighs that will not budge even with diet and exercise. Liposuction patients have great skin elasticity so that the skin looks firm after the procedure. Of course, liposuction is not performed on patients as a weight loss surgery. Also, a woman of childbearing years should consider waiting until she has no plans on becoming pregnant again, as a pregnancy will change the results of the surgery. The best candidates are at their goal weight. Liposuction is not a weight control program. Patients who are obese and those with wildly fluctuating weights are also not good candidates.
These are the areas we commonly liposuction at this practice:
- Love handles or waist area
- Inner and outer thighs
- Medial knees
- Upper Arm
- Back below the shoulder blades
- Submental area just below the chin (very popular at our practice)
Areas that are difficult to liposuction would be the calves and ankles. These are done in rare occasions as the post-operative swelling is significant. These areas are difficult to compress and the swelling leads to skin stretching, which decreases the eventual cosmetic outcome. Another problematic area to liposuction is the inner thigh. It is done frequently; however, the patient must realize that a conservative approach to this area is the most prudent because over suction in this area can lead to mild-to-significant contour irregularities.
Plan Your Procedure
- Procedure Recovery Location
In an outpatient setting, you will be put under a general anesthetic for your liposuction procedure (especially if you are having more than one surgery performed).
Ultrasound-Assisted Liposuction and Standard Tumescent Liposuction
Ultrasound-assisted liposuction is always done in conjunction with standard tumescent liposuction, but not vise versa. To explain further, tumescent liposuction is the installation of saline fluid (salt fluid) with the appropriate amount of Lidocaine (anesthetic) to enhance anesthesia, as well as Epinephrine to shrink the blood supply and decrease the blood loss. With standard tumescent liposuction, the blood loss is minimized, thus maximizing the amount of fat that can be removed. There is a limit to the amount of fat that can be suctioned at any one time, and that depends on your height and weight and the blood loss during the case.
Ultrasound assisted liposuction is used exclusively by some plastic surgeons. It is not used at all by others. Dr. Burns uses ultrasound-assisted liposuction judiciously for certain areas. It helps break up fibrous tissue. It melts the fat in difficult areas allowing an easier extraction. Although that may seem appropriate to use in all patients, Dr. Burns has found that not to be the case as it also has the potential for some mild discomfort that is not seen with standard liposuction techniques. Nerves have fat around them and if the fat on these nerves is melted it sometimes leads to some minor discomfort. In some patients, ultrasonic liposuction may cause increased swelling; therefore, its usage is selected carefully. Dr. Burns uses ultrasound-assisted liposuction for all men with gynecomastia for male breast reduction. He also uses it in all upper back and upper abdomen areas where the fibrous tissue is denser. In addition, Dr. Burns will use it in any repeat liposuction where there is scar tissue. He will usually avoid ultrasound-assisted liposuction on lateral thighs and the lower abdomen.
Once the fatty deposits have been removed via suction, the incision will be closed. Depending on the number of areas treated, your surgery could last 1 – 3 hours. In our dedicated recovery area, your post-operation nurse will help manage your pain, and care for your incision site until your discharge.
What about Laser Liposuction?
Dr. Burns is experienced in all types of liposuction equipment.
What to Expect
There is probably nothing as variable in recovery as liposuction. It certainly depends on the areas treated, as the legs tend to be sorer and have more discomfort than the abdomen. When the love handles and back are suctioned, low back pain and aching are noted by patients on occasion. The patients describe the pain after liposuction as if they had just run 5 miles for the first time all year. It is more a soreness than an acute pain. However, there are exceptions to every rule, and there are some patients who bounce back very quickly within a day or two while others seem to still be somewhat slow to recovery as much as 10 days out. Typically, patients should be able to return to work with most liposuction cases in 10 days; however, they will need to wear a girdle 1 week for each decade of their age, i.e., a 24-year-old patient would wear the girdle 2 – 2.5 weeks, a 45-year-old patient, 4 – 4.5 weeks, etc.
Drains are not used for pure liposuction, although they are used when associated with other procedures, but this is rare. Swelling is routine after liposuction and is the reason that the girdle is worn. The swelling maximizes on day 3 or 4 and begins to abate several days thereafter. You will be encouraged to drink plenty of water during the recovery phase as it flushes the system. It seems counterintuitive to push fluids when one is swelling, but it is critical and decreases the swelling. We encourage at least 64 oz. of water per day and would encourage more if able to do so. Bruising and swelling can be quite extensive with liposuction. It is not unusual for liposuction that is limited to the upper thigh to have bruising down in the calves, ankles, and in rare cases even the soles of the feet.
The risks of liposuction can include contour irregularities. Certainly over-aggressive techniques could result in contour irregularities; however, the most common reason for these irregularities is the fact that there is trauma to the fat with the liposuction cannula itself, which is unavoidable. As a result, there may be minor depressions or irregularities long term. If necessary, these patients with irregularities can have a liposuction surgery touched up, however, it is very unusual for a patient to have a secondary touch up procedure in our office.
Although Dr. Burns has not had skin loss in his practice, it has been reported more commonly by other plastic surgeons implementing ultrasound-assisted liposuction versus standard tumescent suction-assisted lipectomy.
Deep Vein Thrombosis, Pulmonary or Fat Embolus
The most serious complication of liposuction would be a blood clot within the vein or a particle of fat that is introduced into the bloodstream and break off and go to the lung. Every precaution is taken to avoid this, as every patient with liposuction has compression garments placed during the procedure. This essentially creates the effect of massaging the patient’s legs throughout the procedure. This has drastically reduced the overall incidence of this complication. Another measure taken to reduce this risk is limiting additional procedures when doing liposuction. The risk of thrombosis, pulmonary, or fat embolus is low but is something you need to consider when making the decision to undergo this procedure.
Feel Fit and Toned
Without liposuction, you may have put in countless hours at the gym, or just couldn't seem to change your body after baby with regimented diet and exercise. We understand that sometimes fat cells are stubborn, and our office takes appointments for liposuction consultations for this very reason. Whether you want to look better in a swimsuit, or just want a better proportioned body, liposuction can be used to treat many different needs for patients. The results of liposuction may last for many years, and its outcome can be made long-term by maintaining your weight. Call us and schedule today.