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Attempts to eliminate localized areas of increased adiposity or fat by diet and exercise alone are often frustrating, discouraging, and ultimately unsuccessful. Eliminating these areas with the use of liposuction has proven to be a successful method of improving body contour and has earned its position as the most frequently performed invasive procedure in the United States by plastic surgeons today.

SurgeonHouseCall.com, in its continual effort to deliver evidence based knowledge to its members and visitors, presents the following tips regarding liposuction. The following is based on the Practice Advisory on Liposuction presented by the Advisory Committee for the American Society of Plastic Surgeons. The aforementioned is based on a consortium of evidence as interpreted by several leaders in the field of plastic surgery. However, the panel urges that each patient is different and the ultimate decision making should take place between the individual patient and the adequately trained surgeon of their choice.

First, a word on the techniques used for liposuction. Liposuction of any volume over 100 milliliters should include some sort of tumescent solution injected into the area of interest prior to suction lipectomy (liposuction). Tumescent includes saline (a salt and water mixture), usually epinephrine (adrenaline) to decrease blood loss, and lidocaine for post operative pain relief. This tumescent is sucked out with the suction part of the procedure in a ratio of 1:1 to 1:3 of fat to tumescent ratio depending on the technique. In other words, if 2000 milliliters of liposuction is done, only 1000 milliliters of fat will be suctioned.

Large volume liposuction, defined as liposuction of 5000 milliliters or greater of aspirate (equivalent to two and a half 2-liter soda bottles of fat and tumescent solution combination), brings with it greater risk. Evidence is inconclusive regarding any overall improvement regarding large volume liposuction’s benefits on cardiovascular status, resting insulin level, or overall health. However, the benefits of large volume liposuction in addressing contour irregularities during breast, trunk, and thigh body contouring cannot be denied. Safety tips for large volume liposuction include making sure that the procedure is carried out in an accredited center. Also, staying overnight in a care facility so that vital signs and hemodynamic status such as heart rate and urine output is recommended because of fluid shifts that can take place in one’s body after the procedure. Another option, if possible, would be to break up the procedure into several smaller volume liposuctions. Also, combining large volume liposuction with other cosmetic procedures has led to serious complications and it is the recommendation of the advisory panel that these be split up into different days.

Additional safety tips include walking as soon as possible to decrease the chance of blood clots in the veins of the legs and pelvis, deep breathing to open the lungs and decrease the chance of pneumonia, and wearing compressive garments that many surgeons believe decreases a chance of fluid accumulation while the liposuction area heals.

Ultimately, the specific recommendations of your Board Certified Plastic Surgeon should be followed closely and any questions should be addressed prior to the procedure with your surgeon during the consultation or online preconsultation. Liposuction is an excellent tool for body contouring and, when used correctly, can lead to fantastic results and an improved self image for the patient.

For additional information, please visit the forums, online 3D video library, or place a free preconsultation with a Board Certified Plastic Surgeon at SurgeonHouseCall.com.


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