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Liposuction is a highly successful
technique to remove localized fatty deposits that
are resistant to diet and exercise, or that are
hereditary. It is not a means to overall weight
loss.
In Dr. Chartchai's experience,
liposuction is an excellent technique to help sculpture
the body by removing the unwanted fat deposits.
Dr. Chartchai's clients who request liposuction
in Bangkok include men and women who are physically
fit and shapely but who have localized areas of
fat that simply won't go away despite months and
sometimes years of regular exercise, and others
for whom liposuction is a necessary adjunct to a
procedure such as an abdominoplasty in order to
achieve the best results of the plastic surgery.
Subcutaneous fatty tissue, which
exists above muscles and under the skin, is a well
defined layer that creates softness and hides the
angularity of the bones of the body. When excess
fatty tissue is deposited in certain areas, a person
looks overweight.
Unwanted fat cells are removed
with their accumulated fat, leaving behind connective
tissue, the blood vessels, and the nerves. The space
left after the fat cells are removed is obliterated
with small amounts of scar tissue. With liposuction
the cells and fat that are removed will not regenerate.
Liposuction causes a permanent change in the shape
of the body.
What do you want to change?
The usual goal for liposuction is improvement,
not perfection. Having realistic expectations can
make the entire experience much more satisfying
and reduces the chance of disappointment. If at
the start of the process you have tight, hard skin,
then you will probably end up the same way, but
with better contours. If your skin surface is wavy,
dimpled or wrinkled to start with (indications of
cellulite), the contours of your body will improve,
but the surface may retain the same wavy, dimpled
appearance.
The ideal candidate is a healthy
person with good skin tone who is within 30% of
his or her ideal weight. Liposuction is not recommended
for people with diabetes, heart or lung conditions,
a history of blood clots, anemia or poor skin tone.
Liposuction is useful for the
following areas: lower abdomen, calves and knees,
inner and outer thighs, hips and flanks, buttocks,
love handles, back and chest, upper arms, neck and
jowls. Liposuction can get rid of stubborn fatty
deposits, especially in the upper arms and love
handles, where usually no amount of dieting, sit
ups or push ups will help.
Cellulite responds poorly to liposuction.
Cellulite is deposits of subcutaneous fat separated
by fibrous septa that creates a dimpling or bulging
effect on the overlying skin. Sometimes when this
fat is removed the dimpling can become more prominent.
A beer belly cannot be reduced
by liposuction. This fat is not subcutaneous fat.
It is found under the muscle within the abdomen
itself. It is sometimes called mesenteric fat. It
not accessible by liposuction and can only be lost
by diet and exercise.
Procedure
The procedure, using local or general anesthesia,
can take anywhere from 30 minutes to a few hours,
depending on how much fat is removed, how difficult
the fat is to reach, and how many areas are being
treated at one time.
Dr. Chartchai performs tumescent,
or superwet, lipoplasty,
whereby large volumes of saline solution mixed with
local anesthetic and adrenaline are injected into
the fat to make cells easier to remove. A small
hole is made so as to be later hidden in a crease
of the body. A hollow metal rod connected to a high-powered
suction pump is inserted into the hole to suck out
the fat.
The amount of fat removed varies.
If the body build is average but the patient has
excessive fatty deposits, the maximum amount of
fat to be safely removed at one operation is 4 liters.
Liposuction never removes all
the fat cells in any area. Some fat cells are always
left behind and are necessary to provide normal
contours.
There is no evidence that ultrasound
assisted liposuction (UAL) provides any advantages
over conventional tumescent liposuction despite
the claims made by those who market it.
Recovery time
Post surgery there will be swelling, bruising
and a burning sensation in some areas. A compression
garment must be worn for 4-6 weeks after the surgery
to control swelling and to shape the skin to its
new contour. After 6 months, the swelling will subside.
You may return to work depending
on the amount and size of the area that has received
liposuction.
There will be some swelling and
bruising, and possible numbness or a burning sensation
at the treated areas. After liposuction, the skin
needs to shrink to its new contour and this takes
time. A compression garment should be worn for 2-4
weeks to control swelling and shape the skin. Within
6 months the swelling will have subsided.
Strenuous exercise may be resumed
after a month or more - Dr. Chartchai will advise
you what is best for you.
Older patients whose skin is
no longer lax, or women whose abdominal skin is
badly stretched, may need to have the resulting
excess skin removed as it will not shrink back to
tightness.
Time off work is highly dependent
on how large of an area is liposuctioned. If a single
area is liposuctioned then it may be possible to
return to work the next day after surgery. As more
areas are liposuctioned the amount of bruising and
swelling increases and the recovery time increases.
Possible complications
Bleeding and infection may occur. Some common
risks are uneven contour, dimpling and skin surface
irregularities. Other complications include nerve
damage, excessive fluid retention, blood clots and
perforation of organs. A fat embolism is a rare
but possible complication found in large volume
liposuction.
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