Tumescent Liposuction

Every year New Zealanders spend millions of dollars on dieting, exercise and attempts to attain slimmer, more attractive figures. The truth of the matter is that despite careful dieting and exercise, few people genetically have a perfect shape.

Our distribution of fat is determined by puberty. After this time no further fat cells are produced. As we gain weight the fat cells expand and when we lose weight the fat cells contract. However the proportion of fat in one area compared to another does not change.

Liposuction was first developed in the 1970's to remove undesired fat from nearly all body areas, including the face, neck, chin, breast, abdomen, hips, flanks (love handles), inner and outer thighs, buttocks, knees and ankles. The original procedure used large instruments and general anaesthesia and had significant complications.

What is the Tumescent Technique?

Several years ago a dermatological surgeon, Dr Jeffrey Klein, developed a major advancement called the tumescent technique which completely revolutionised the procedure. The new tumescent liposuction allows the safe and effective removal of deep and superficial layers of fat under local anaesthesia or intravenous sedation with relatively little discomfort, virtually no complications and improved cosmetic results.

What is Liposuction?

With tumescent liposuction, large volumes of a solution containing diluted Lignocaine (a local anaesthetic) and diluted adrenaline (a drug to shrink capillaries and prevent blood loss) are injected with minimal discomfort directly into areas of excessive fatty deposits. Once the liquid is injected, tiny incisions are made in the skin and a tube (called a cannula) connected to a vacuum is inserted into the fatty layer. Using to and fro movements, the fat is drawn through the cannula into a collection system.

The tumescent method enables cosmetic surgeons to remove large amounts of fat uniformly with fewer skin irregularities and less bleeding and bruising. An elastic compression garment is worn for up to 4 weeks following the procedure which helps to control bleeding and swelling and also helps the skin shrink to fit the new contour. The longer the garment is worn, the better compression and contouring achieved.

Liposuction is not intended as a substitute for weight loss programmes but rather as a contouring technique. It is used as a shaping procedure for areas where hereditary fat deposits resistant to diet and exercise have accumulated. Although a solid exercise programme and good diet can ensure that the treatment will create the best results, overweight patients with specific problem areas can also be good candidates for the procedure.

The best results from liposuction occur in areas where there is reasonable muscle tone, where skin has good elastic quality and where fat is not excessive. The areas treated at Oxford Clinic are:

• Upper and lower abdomen
• Outer and inner thighs
• Hips
• Flanks (love handles)
• Buttocks

It is recommended that therapeutic massage be commenced approximately three or four days following the procedure and most clients require approximately 5-7 sessions in total. Contact details for a massage therapist will be provided by the Clinic. As it can be difficult to arrange appointments at short notice, it is advised that patients contact the therapist in advance of their surgery to arrange the first massage session.

Liposuction can enhance your appearance and your self confidence but it will not necessarily change your looks to suit your ideal. The results are permanent providing you eat sensibly and exercise regularly. It is up to you to maintain your liposuction results with a healthy balanced lifestyle.

Most patients are very satisfied with the results of their liposuction - they feel more comfortable in a wide variety of clothes and more at ease with their bodies. As long as expectations are realistic patients are generally very happy with their new shape.

Commonly Asked Questions

• Are there any risks associated with liposuction?

  As with any surgery, there are always potential risks and side effects. These have been minimised with the improved techniques.

  Blood Loss: Due to new techniques blood loss is minimal. The tumescent solution reduces the risk of bleeding.
  Infection: Infection is rare but can be serious. A 7-day programme of antibiotics is taken during and after the operation.
  Scarring: Small incisions are made in the skin during liposuction and a thin tube is inserted into the fat. Even though these incisions are very small they may be visible for the first six months.
  Skin Irregularity: With the older methods of liposuction, irregularities did occur due to the large instruments used. Nowadays smaller instruments are used so this is less likely to occur. It is important to wear compression garments in order to allow the skin to heal evenly.
  Numbness: It is common to have numbness following liposuction due to trauma of the nerves under the skin. This condition will gradually improve and return to normal over time.
  Pain: Some tenderness and discomfort is to be expected following liposuction. Any pain will greatly improve after the first week. Regular pain relief is prescribed.
  Loose Skin: Following liposuction, scar tissue is created under the skin. This enables the skin to "shrink." The younger and more elastic the skin, the better it shrinks. However, even older, less elastic skin will shrink to some extent.
  Allergy: Reaction to the local anaesthetic is rare but may occur.

• Can Liposuction be performed under LOCAL anaesthetic?

  Yes. Small areas can be successfully treated under local anaesthetic. Typical areas are ankles and touch up areas. Under local anaesthesia you will feel some vibration and friction during the procedure. You may feel a stinging sensation as the cannula moves closer to the muscle.
  This service is not offered at Women's Health but we can make arrangements with another facility for these areas to be treated.

• How does Liposuction differ under intravenous sedation?

  The procedure itself does not alter. The difference is you are asleep throughout the entire procedure. You cannot go home straight away as recovery time is required at the Clinic. The cost is greater as there is an anaesthetist fee involved. You are also required to have a driver to and from Oxford Clinic and must have someone stay with you for the first 24 hours following the procedure.

• Who measures me for my garment?

  An appointment will be made for you prior to your surgery date when your pre-operative photos and garment measurements will be taken. During this consultation any further questions you may have will be addressed. Your procedure consent will be signed at this appointment.

• How long should I wear the support garment?

  All garments should be worn for 24 hours a day for the first week following your procedure and for 12 hours a day during the second and third weeks. You may need to wear your garment for four weeks, depending on the area treated. The garment is billed in addition to your surgical fee.

• When can I expect to see results?

  In most cases a change is noticed immediately. The best results show at three months, during this time you can expect continual results.

• How long do I need off work?

  Some people go back to work the next day. Most people return to work within a few days, although a week off may sometimes be required.

• What happens if I put on weight?

  If weight gain occurs, the remaining fat cells will increase. This means you will gain weight more evenly rather than accumulating it in the same treated area.

• If I have liposuction to one area will I automatically get fatter in another spot?

  No. This is a common misconception. If you gain weight overall you may put it on in other areas. If, however, you do not gain weight you will not automatically get bigger elsewhere.

• How many times can I have liposuction?

  There is no limit. However, the best results are obtained with the first procedure. After the first liposuction, scarring occurs which makes the fat more difficult to remove the next time. If you are choosing to have many areas treated it may be recommended you do it in two separate sessions.

• When can I exercise after liposuction?

  Within your level of comfort, you may undertake limited exercise after one week.

Payment

You will be asked to pay a deposit for liposuction at the time of procedure booking. You will receive an invoice via the post or at your pre operative appointment. This is to be paid for in full 10 days prior to the cosmetic procedure.

Process for referral for the procedure

Before your surgery you will need a consultation with your surgeon to assess your suitability for the procedure and to discuss possible undesired effects and contraindications. You will also have a consultation with one of the clinic nurses to prepare you for the surgery and discuss any concerns.

To make an appointment with gynaecologist, Mr Michael East, who is qualified to undertake these procedures, you can contact his nurse at Oxford Clinic on 379 0555.