What is liposuction (Lipoaspiration)?


Liposuction is not something new in the modern medicine. Nevertheless this procedure is till popular and it is quite possible to say hat it becomes even more popular as the time goes by. Commonly people have only dim understanding of this procedure. Thus we decided to consider it a bit closer and describe all its types that exist today. The article below is intended for those interested in the liposuction methods and those planning to have it in the nearest future. Furthermore, please not that the visit to your doctor is nevertheless required before taking decision of carrying out this procedure or not.

Despite the great number of the liposuction methods they have one and quite clear principle in common. The excesses of the adipose tissue are being removed via the special tube called cannula. It is being placed into the hypodermic space under the pressure provided by the special apparatus.

When the liposuction is to be used?

The obesity is divided into two types – the local and generalized one.

The local type of the obesity is not affected by certain physical exercises and diets and it is mostly appears in women. It reveals itself in quite definite shapes and commonly presents at the outward hips surface, internal knees surface, flanks (side parts of the waist), the front abdominal wall area, genial area and etc. This type of the obesity is the main indication for the liposuction with the positive esthetic result in the end.

Generalized type of the obesity – is the result of the metabolism misbalance caused by the genetic, constitutional factors as well as incorrect nutrition schedule or physical loadings. The generalized obesity form is characterized by the hypertrophy of the all levels adipocytes. A person experiencing this obesity type is looks like sumo wrestler. Similar disorders are quite senseless to treat with the help of liposuction. They should be treated with the conservative methods implying the interference of physicians, endocrinologists and dieticians.

When the liposuction should not be carried out?

  • In case of severe chronic somatic diseases.
  • In case of endocrine obesity.
  • In case of revealed disorders of the skin elasticity.
  • In case of individual intolerance of local anesthetics (that are applied in certain liposuction types).

What is the standard liposuction?

Standard liposuction is divided into two modifications: the “dry” and the “wet” one.

The dry one implies the insertion of the cannula with one or several holes at the end through the small incisions (up to 0.5 cm) under the skin. Another end of the cannula is connected to the vacuum apparatus that provides the negative pressure thus removing the fat. Fan-shaped insertion of the cannula with the translation is responsible for two processes at the same time: the mechanical destruction of the fatty tissue and its vacuum aspiration. Probably it would be clearer for the patient in case we will compare this liposuction type with the process of the dust removal with the help of vacuum cleaner.

The standard method is considered to be the most traumatic one as it implies the largest affection of the soft under skin tissues accompanied with the corresponding bleedings as well. The volume of the fat removed is quite limited and it shouldn’t be over 1-3 liters as certain authors says.

The wet liposuction type differs from the dry one only with the fact that the operation area is being pricked all round with the local anesthetic solution with the aim of dissolving fatty tissues and therefore its easier removal.

Another quite important moment is that the wet liposuction should not be confused with the tumescent type that implies the prior infiltration with the help of the special solution under the certain conditions.

What is the tumescent liposuction?

The essence of the method implies the prior infiltration of the operation area with the Clein solution that contains increased lydocaine and adrenalin doses. The Clein solution is injected under the great pressure (commonly it is done with the help of the infiltrator) in order to provide its equal dissolving deep in the tissues. Due to the great pressure and the large amount of the liquid injected as well as the diffusion the blood vessels narrows considerably and the adipocytes increase thus making the aspiration easier.

However a certain pause is required between the infiltration and the operation. It usually takes from 30 and up to 60 minutes.

Tumescent liposuction is the most popular plastic surgery in many countries and USA as well. According to the data provided by the American Association of the plastic and reconstructive surgeons the number of the liposuction procedures increased up to 200% in the year 1997 when compared to the data of 1992.

What is the hydroliposculpture?

Hydroliposculpture is one of the tumescent liposuction types. However it was singled out as the separate method due to the fact that it differs significantly of the other liposuction types. These distinctions imply the carrying out the liposuction procedure with the help of long, thin, flexible and hollow needles and not the cannules. The needles intended for this procedure penetrate the fatty tissue in soft and not rough way.

At the same time needles bend thus corresponding to the skin relief. To provide the minimal damages the needles are inserted via the special Teflon adapter. As the needles are quite thin (below 0.3 cm) the hydroliposculpture is not carried out in case a large amount of the fatty tissue (over 1.5 kg) is to be removed. On the other hand hydroliposculpture may be quite effective as the final step in any other liposuction procedure when the additional “thin” correction is required to provide the most flat shape. The use of this liposuction type makes it possible to remove the thin fat layer adjacent to the skin without any deformations.

The hydroliposculpture commonly doesn’t cause such complications as edemas, infiltration hematomas that are quite usual in other liposuction types.

What is the spray liposuction?

Despite the fact that the surgeons mostly use vacuum-aspiratory apparatus the application of spray liposuction is also quite popular one. The most obvious disadvantage of this method is the considerably longer period of time required for the procedure. At the same time there are many advantages of this method. The negative pressure made by the syringe is quite lower than the one made by the vacuum-aspiratory apparatus. The tissues are less damaged through the spray liposuction procedure thus the postoperative period is quite shorter, and the edemas and bruises are cured sooner.

The next and quite important advantage of the spray liposuction is that the surgeon controls every step of the procedure completely and is able to make the optimal shape speed of the operation the spray liposuction is available for removing only small amounts of fatty tissues. However this is not an obstacle for certain surgeons in removing several liters of the fatty tissue, the process requiring several hours.

What is the ultrasonic liposuction?

In case other liposuction types imply the removal of the adipocytes via mechanical way the ultrasonic liposuction type implies the ultrasonic destruction of the cells. Thus the following aspiration removes already more compliant fatty emulsion appeared due to the ultrasonic affection. The ultrasonic liposuction postoperative period is similar to the other operation types’ postoperative periods: the antibiotic intake (5 days), compressive wear use (4 weeks), self massage.

What is the lipomodelling?

The difference between electronic lipomodelling and other liposuction types is that the fat aspiration stage is being foregone by fatty tissue dilution with the high frequency electric field. The electric field occurs between thin needles inserted into the tissues. The needles are connected to the programmable generator that provides this field.

The high frequency electric field provides not only local heat effect causing the fatty tissue dilution but it also destructs the adipocytes membranes thus provoking the fatty emulsion appearing. These both facts ease the process of the fat aspiration and thus enable the use of quite thin cannules throughout the process of electronic lipomodelling.

Supporting this type of liposuction the adherents of this method insist upon the fact that the patients avoid such unpleasant complications of the Ultrasonic liposuction as burns. Skeptics suppose that the ultrasonic is more radical way of even fat emulsification.

What are the complications after the liposuction?

The most unpleasant esthetical complication is the irregularity of the skin profile i.e. those things the patients are commonly calling as pits, sockets and etc. This may occur due to technical errors throughout the operation (for instance such as a removal of too large amount of the fatty tissue or uneven removal of the fatty tissue), postoperative under skin scarring or insufficient retractive skin ability.

Below is the list of the most unpleasant esthetical complications throughout liposuction.

Esthetical complications:

  • irregularity of the skin profile;
  • chronic edemas;
  • pigmentation;
  • skin necrosis in the operation area.

Clinical complications:

  • excessive blood loss;
  • seromas;
  • hematomas;
  • hyperesthesia;
  • infections;
  • thromb embolism of the pulmonary artery;
  • fat embolism (appearance of the destructed fatty tissue in the blood flow).

Will new fat appear in the liposuction area?

It is used to consider that the liposuction being carried out correctly is the onetime procedure. In other words there won’t appear new fatty tissues in the area of the removed one.

This is really so and there is a scientific explanation to this fact. The matter is the number of the fatty cells in the body of the adult person is not the constant one. In other words obesity or uneven spread of the fatty tissue doesn’t relate to the growth of the adipocytes number but with their size growth.

Thus the liposuction is unable to normalize lipidic exchange and the incorrect utilization of the fats and carbohydrates provided with the food will further provoke the swelling of the fatty cells in those areas out of the liposuction areas. Thus the obligatory term for the patients experienced lipoaspiration is the toughening of the foods ration. Otherwise the disproportion between two skin areas that took and didn’t take place in the liposuction procedure will be too obvious.

What parts of the body shouldn’t take part in the liposuction procedure?

Unfortunately not all parts of the body are to be exposed to liposuction with the positive results. The zones that are better not to involve into the process are such as climacteric hump (the seventh cervical vertebra proection), upper and the middle thirds of the back, shanks, shoulders, the front hips surface. For instance the liposuction of the back shanks surface with the considerably thin fatty layer there is a risk to get obvious asperities of the skin.

The liposuction of the back the skin is unable to retract sufficiently to provide ideal visual effect due to local anatomical features. In other words the fat is being removed but the skin is in wrinkles.

The shoulder liposuction the preoperative situation worsens: the skin sags more than it was before the operation. This situation requires more surgeries.

What amount of the fat may be removed?

The possible volume of the fat to be removed is still too disputable question. There are adherents of quite delicate operations (below 500 ml), as well as those supposing it is better to remove considerable fat volumes (up to several liters).

The removal of 3-4 liters of the fat throughout the tumescent liposuction is experienced quite commonly by the patients. There are even such reports saying about the removal of 16 kg of the fat! The patient was a woman of the 61 years of the age experienced hormonal disorders and possessed a weight of 96 kg. A tumescent spray liposuction was applied in this case.

Considering the fears concerning the large amounts we should note that the main factors causing such fears are the inevitable blood loss as well as unavoidable changes in the general lipidic exchange. The optimal situation should imply certain balance between esthetical result and fulfillment of the conditions that are not dangerous for the patient’s life.

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