Liposuction
The following areas can be treated with liposuction on both men and women: double chin, upper arms, breasts, abdomen, hips, buttocks, so-called “saddle bags” or “riding breeches”, outer and inner thighs, lower leg, calves. The most modern and safest form of liposuction is the so-called super-wet method performed under local anaesthetic. It is the only liposuction method currently recommended. When selecting a surgeon, it is important to choose one who operates according to this method.
Liposuction techniques have changed considerably in recent years. In the early days of liposuction, the patient was put under general anaesthesia and the fat cells were torn out without liquid injection using a cannula up to one cm thick. This usually caused a significant amount of bleeding and sometimes even embolism, which affected the patient’s health for an extended period of time, even resulting in death in some cases. Today, the risk of death from liposuction surgery is only a factor when performed under general anesthesia. Liposuction techniques have since been improved upon with the use of small amounts of fluid containing adrenaline to reduce bleeding (wet technique, sometimes incorrectly referred to as tumescence). Experiments with ultrasound assisted liposuction have also been made, but because of the extensive degree of heat applied through this technique, it carries the risk of damage to large areas of the skin and under-skin damage.
Not until twelve years ago did Jeff Klein, an American dermatologist, discovered an important breakthrough, later improved upon in Germany by Prof. Mang and Dr. Sattler. With the patient under a local anesthesic, a substantial amount of saline solution and other substances are used to numb the areas where liposuction is to be performed. Also, during the 45-minute period in which the substances take effect, the fat cells are “watered down”, allowing the golden-colored fat to be suctioned using an extra fine needle (two to three millimeters) and causing only a slight amount of bleeding. The only disadvantage of this technique has to do with the difficulty in dosage of the tumescence solution: to avoid an overdose and subsequent side effects from the injected substances, no more than approx. 6 to 7.5 liters (dependent on individual weight) should be injected and no more than four liters of fat should be suctioned. For safety reasons, the operating surgeon must adhere to this rule, which means that patients with several or extensive problem areas must undergo liposuction a second time approx. three months later to achieve best results. Your surgeon will discuss your individual case and the estimated limits prior to your operation.
Besides the technique being particularly safe, it is also the only one which allows the skin to tighten subsequent to surgery, as damage to the under-skin structure is minimal. Nevertheless, this form of liposuction does have its price, as it is time consuming. The complete procedure takes almost four hours. For both safety and practical reasons (for the first twelve hours after surgery, large amounts of secretion seep from the punctured areas where the skin is merely glued), it is recommended that patients receiving major liposuction treatment spend the first night at the clinic. The procedure can, however, also be performed as an outpatient operation if preferred by the patient, particularly if only small areas are to be treated.
Seven days following surgery, it is necessary to wear a supporting bodice at all times. After this, the bodice should be worn for a further four-week period as often as possible, aiding the tissue to condense well and regain its elasticity. The tightening effect can be quickened and increased by a lymph drainage, which can be carried out from day five. After four weeks, it is no longer necessary to wear the supporting bodice. The patient may resume sports activities starting the second postoperative week, but should refrain from use of sauna and solarium for at least one month. In rare and exceptional cases, redness, fever or severe water retention in the legs may occur. This requires immediate consultation with you doctor, and urgent examination by your surgeon. As a postoperative measure, directly after surgery, the patient must get up once every hour up until midnight and move about for approx. 10 minutes. This is a thrombosis preventative measure to assist the release of tumescence solution still remaining in the body. To further minimize the risk of thrombosis, responsible surgeons will conduct a so-called APC resistance and glucose-6-phosphatdehydrogenase test prior to surgery. If the test reveals a high risk, surgery should not be performed, or only under certain precautionary measures, since the procedure is not medically indicated and all known risks must be avoided. It is normal for hematomas to occur for up to three weeks. If you experience extensive pain, please contact your surgeon or a general practitioner in your area.
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