LIPOSUCTION

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In a modern society a thin body is becoming very popular, if not even an obsession. Many are able to achieve such a body through diets and exercise. However, there are many patients for whom that is not enough. Such patients (both men and women) represent potential candidates for liposuction. According to statistics of many plastic and aesthetic surgery societies, one of the most popular aesthetic surgeries is liposuction.

It is important to note that liposuction is not used to remove body weight excess, but that its indication is shaping of the body.

Liposuction can be done at the same time on several regions of the body and can be done in combination with other aesthetic surgeries.

LIPOSUCTION CANDIDATES
Liposuction is especially good for patients that have relatively normal weight, but have noticeable amount of fatty tissue in region of belly, thighs or some other part of the body, so that they look disproportionate. These localized fat deposits can sometimes be a hereditary attribute and cannot be removed through diets or exercise. Liposuction is often the only way to eliminate them.

The ideal liposuction candidate is a young, relatively thin person with localized fat deposits and tight skin.

Averagely ideal candidate for liposuction is a person between 30 and 45 years of age, weighing 5 to 10 kilograms above ideal weight and with small degree of skin flabbiness.

The least ideal candidate is usually a person older than 35, with 20 kilograms over the ideal weight, with scars, striae, ptosis of the buttocks and with severe skin flabbiness.

PREOPERATIVE PATIENT ASSESSMENT
Liposuction can be done at any age, however best results on the skin will be gained if the skin is elastic enough to get a smooth contour after its removal. When the skin is not elastic, which is sometimes the case with older patients, it cannot tighten enough and the procedure of tightening is needed (dermolipectomy or thigh lift). Liposuction is popular also with men, especially for elimination of fatty tissue around the waist.

Localized fatty tissue deposits are often found on hips and thighs, abdomen and waist, inside and outside of thighs, inside part of the knee, lower leg, cheek, jaw and neck, upper part of the arm, in breasts or chest and back areas.

If you wish to undergo this type of surgery, during the first consultative interview you have to discuss with Dr. Milan Jovanovic your wishes and expectations, and he will assess if they are real or not. If you decide to undergo this surgery, you have to point out what illnesses you had, if you had any surgeries previously or if you are allergic to some medications and if you are using some medications. Drugs like aspirin, anticoagulants, vitamins, estrogen must not be used for a week after the surgery. How heavy you are and if you plan to take care of your diet and your food consumption habits in the future. It is very important to give a complete information.

Dr. Milan Jovanovic will also assess you skin flexibility and amount of fatty tissue that needs to be removed to gain an optimal result.

LIPOSUCTION PROCEDURE
This surgery can be done in general or local anesthesia with intravenous sedation, depending on the size of the area being treated and patient commodity.

Nowadays are three liposuction procedures being used, so called suction‐assisted lipoplasty, power‐assisted lipoplasty and ultrasound‐assisted lipoplasty.

The most common is suction‐assisted lipoplasty which is done with special aspiration cannulas of different length, shape and diameter. First, cannulas are used to physically break fatty tissue that is previously infiltrated with specially prepared solution, so called "tumescent" technique that introduces large amounts of liquid or its variations. Earlier has been used so called "dry" technique that is less used today. Then, through openings on the tip of cannulas, fat cells are sucked up using vacuum. Liposuction can be done in deep or surface fatty tissue layer. Which technique is being used depends on objectives set preoperatively.

After the surgery a corset is put on that is worn for a couple of weeks. This surgery shapes the body, so many surgeons call it liposculpturing.

Liposuction can be done in hospital or outpatient conditions. Before the surgery premedication is received. You and your plastic surgeon will decide on type of anesthesia being used. During the surgery, your heart function, blood pressure, pulse and oxygen levels in your blood are monitored. After the surgery your monitoring will still be watched. After a few hours you can go home or (if your surgeon decides) you can stay for the night in the surgical ward.

COMPLICATIONS
Complications that can arise through liposuction are: hematoma (that subsides after a few days), infection, skin numbness (which is temporary) and contour irregularities as bumps. Serious danger from liposuction are fat embolism and thromboembolism.

POSTOPERATIVE TREATMENT
After the surgery a special corset is worn that helps tightening and regular attachment of skin. Clothing is worn immediately after the surgery and is worn for a couple of weeks. Liposuction recuperation varies from person to person. First day after the surgery you have to get up in order to improve circulation. You have to constrain yourself to short periods of light activities during the first few days. Remember that you must not take aspirins or some other anti-inflammatory medicines and you should not smoke during these few days.

First changing of bandages will be after two to three days. Bruises and swellings may be visible. Swelling usually starts to subside during the first seven days, while bruises can last even up to three weeks and longer. Numbness in some areas may also appear that can last up to couple of weeks before normal feeling returns. If sutures were used, they are usually removed on tenth day after the surgical procedure.

In most cases you can return to normal activities after one to two weeks (sometimes even in a week) and start with some form of exercise immediately after that. Time for a full recuperation depends on extent of surgical procedure.

Extended bruising and water retention can sometimes cover up achieved results. That is why sometimes it takes up to six weeks for you to see the true results and to be satisfied.

Liposuction results are going to be permanent if you keep your postoperative weight. If you gain weight, fatty tissue accumulates evenly and not in the areas that were problematic.

After the surgery you have to regularly report for check-ups that will be scheduled for further observation.