Northern Virginia- Fairfax and Manassas
By: George Bitar, M.D. and Larry Lickstein, M.D.
Board Certified Plastic Surgeons
For people who diet and exercise, but have a few extra pounds that are stubborn, or some areas of their body which are not proportionate, liposuction may be the answer. In men, it is usually in the love handles and abdomen. In women, it is usually in the hips and thighs. The fat cells are removed forever, but the remaining ones can enlarge if the patient gains weight. A good candidate for this procedure will have good muscle and skin tone, with mild to moderate extra fat. It is important to note that liposuction should not be used as a weight reduction tool. Since some blood is suctioned out with fat, it is not safe to have huge amounts of fat liposuctioned. Based on arbitrary guidelines set forth by authorities in the field of plastic surgery, we try to limit the amount of fat removed in a liposuction operation to a maximum of about ten pounds.
Preparing for Surgery
An initial consultation is set-up where we discuss the liposuction procedure, and whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery. You are asked to stop smoking, if you are a smoker, two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.
The Liposuction Procedure
If the patient has good skin tone, good muscle tone, and minimal or moderate extra fat, then liposuction will offer a very viable option to achieve that desired contour. The advantage is a quicker recovery period, and minimal scarring. This procedure takes about one to three hours, depending on where and how much liposuction is going to occur.
The procedure is relatively simple and straightforward. A patient, who is deemed a good candidate for this procedure, is given antibiotics, and anesthetized in the operating room. The body is injected with tumescent solution to give some pain relief and decrease the bleeding during surgery. Small incisions are made around the area agreed upon during the initial consultation, and liposuction is performed to remove the desired amount of fat. When sufficient fat is removed, the incisions are closed and the patient is awakened. Typical areas liposuctioned are upper arms, neck, chest, abdomen, flanks (love handles), back, buttocks, hips, outer thighs, inner thighs, knees, and ankles.
How We Minimize Complications of Liposuction:
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible , anticipating problems or set-backs, and addressing them before they happen. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class hospital with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.
Before surgery, our patients are tested to make sure they do not have any common bleeding disorders by their own physicians, and by lab tests. Bleeding with any form of liposuction is rare. Before liposuctioning the body, we inject tumescent solution that will constrict the blood vessels and minimize the bleeding. In our practice the rate of significant bleeding has been minimal.
The most important step in avoiding infections/wounds, in our opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, our patients are prescribed a one-week course of antibiotics to minimize infection. As a result of these extra precautions, my rate of infection after liposuction is extremely rare. Since with liposuction there is no skin removal or tissue manipulation, other than suctioning fat out of the body, open wounds are extremely rare.
We exercise caution around the nerves in the body and avoid aggressive liposuction, minimizing nerve injury. Temporary loss of sensation from a “stunned” nerve or a bruised nerve may occur in the time period after surgery, but sensation in the vast majority of cases returns within a few weeks.
Irregular Skin Contour
Since fat is liposuctioned from underneath the skin, and the skin is left intact, then some minor skin surface irregularities can form. This is common in liposuction, and is not clinically significant or noticeable except under very careful observation. In rare instances, either an excessive amount of fat is removed, or appropriate liposuction is done but the skin retracts abnormally. In this situation, a significant skin irregularity may form. The treatment is either liposuction around the area, fat injections into the area, or both, to smooth it out. This technique is highly effective and successful.
Our office will provide you with a detailed post-operative instruction sheet that will be individualized to your needs. We usually see patients the day after surgery in one of our offices to make sure that everything is O.K., and that you are healing as planned. Multiple visits in the year after the procedure will ensure the best outcome possible.
For more information about this procedure call our office and speak to our friendly staff member at 703-206-0506.
Information on this web site is for information only. Do not use the information to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.