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It is imperative that patients refrain
from ingesting any medications or other substances which
could potentially be the cause of surgical complications.
A list of medications should be reviewed and discontinued
at least two weeks prior to operation. Patients are
seen just prior to their surgery date for a general
physical examination to ensure that no underlying medical
problems exist which may interfere with the safety of
their surgery. Specifically, any infections which arise
prior to operation, however seemingly trivial, should
be reported to our office. Even an otherwise innocent
infection can result in a disastrous surgical wound
infection, and must be treated prior to surgery.
Prophylactic antibiotics are prescribed
prior to and for a few days after surgery to reduce
the risk of surgical wound infection. A prescription
for pain medication is also written, so that you have
your pain pills when you return home from the operation.
Pre-operative photographs are taken
so that you can see the improvement from your surgery
afterwards. We generally take post-operative photographs
at 3 months after your procedure.
You will need to arrange for an escort
to drive you to and from our surgical center. Patients
cannot operate motor vehicles after surgery, and we
will not place recently sedated patients into taxis
for transport home. We can arrange for medical transport
in the event you cannot find an escort. It is mandatory
to have someone stay with you for at least 24 hours
after surgery, for your comfort and safety
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Most liposuction procedures are performed under a combination
of local and general anesthesia, with some small volume
procedures being done under local anesthesia with sedation.
The anesthesia requirements for your procedure will
be discussed with you by Dr. Parker at the time of your
consultation.
Skin markings are made to outline the sites to be treated.
The anesthesia is then administered, and in every instance
the fat is infused with a very dilute local anesthetic
to distend the fat cells, which makes it easier to extract
them and improves the ability to contour the areas smoothly.
Dr. Parker uses a technique known as ULTRASONIC LIPOPLASTY
(UAL) to treat many areas of the body. This involves
the use of a cannula which has ultrasound waves emanating
from the tip. These sound waves break apart the fat
cells, releasing their contents and making it less traumatic
to sculpt the tissue. Rather than just suctioning the
whole fat cell out, often in clumps, this technique
removes the free contents of the cells and the ruptured
membranes of the cells separately. The rationale is
that smoother results can be obtained with this technology.
One of the problems with liposuction in the past has
been visible irregularities in the skin of treated areas.
UAL has made this less of a problem, in general. Another
advantage is the ability to remove much more fat without
any appreciable blood loss. Yet another advantage is
the ability to remove fat from very fibrous areas, such
as the back and the upper abdomen, which is much more
difficult with conventional suction-assisted lipectomy
(SAL).
After a period of at least an hour to monitor you in
our recovery room, you will be discharged into the company
of an escort.
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The compression garment is
worn for several weeks. Most people can return to work
and regular activity in a few days. However the level
of activity is dependent on the amount of fat removed
and the number of areas effected.
You will almost certainly experience
some fluid drainage from the incisions. which is minimal.
This drainage usually stops within 48 hours. At that
point, you will be seen in the office and the initial
dressings removed and all incisions checked. You will
then be able to shower, but you will be asked to wear
your compressive garment for approximately a month.
This helps to control swelling and to assist in contouring
the skin back down to the underlying muscle. The garment
can be laundered after the first follow-up visit.
Certain side effects of liposuction,
whether UAL or SAL, include pain, burning, swelling,
bruising, oozing (blood-tinged fluid), and temporary
numbness. The pain is usually well controlled with the
prescribed medication, but a feeling of soreness persists
for several days to several weeks. It takes at least
six weeks to begin to feel normal again. The skin is
usually quite numb and feels very hard to the touch.
It may even take as long as six months for the tissues
to feel absolutely normal, depending on the extent of
the procedure.
Most patients return to sedentary
type work in a few days to a week, to physical work
in one to two weeks. Though moderate exercise (e.g.
walking) is encouraged in the early post-operative period,
vigorous exercise such as swimming, jogging, aerobics,
and weight training should generally be avoided for
about a month. Dr. Parker will be following you on a
regular basis to give you specific feedback about your
activity level.
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Liposuction
