The following is information regarding suction lipectomy surgery which is important to review, understand and discuss with family and/or friends before choosing to proceed with this surgery.
GOALS OF SUCTION LIPECTOMY
Suction lipectomy is a procedure which removes fat cells through small incisions utilizing surgical suction catheters. The goal of surgery is to improve body contour by removing localized accumulations of fat. This will establish more normal proportions between various areas of the body and improve the appearance both in and out of clothing. Suction lipectomy is not a treatment for generalized obesity, but rather is indicated for well defined localized accumulations of fat. In any given patient, these goals may be only partially met.
LIMITATIONS TO THE PROCEDURE
This procedure will not improve body contour where diffuse obesity is the underlying problem. In addition, excess or loose skin will not be improved. Body contour irregularities which are due to structures and tissues other than fat are not improved by suction lipectomy (for example, muscle weaknesses or bony asymmetry). Skin dimpling (“cellulite”) which is present before surgery will remain after surgery. Skin elasticity is not improved by this procedure. The ability of the skin to shrink over new contours following suction lipectomy is generally better in younger patients than older patients. The more fat removed from an area the more difficult for the skin to shrink smoothly over the new contour regardless of age. This can result in skin laxity, rippling, dimpling or other skin irregularities.
ALTERNATIVES TO THE PROCEDURE
Suction lipectomy is a purely elective procedure designed to alter body shape. Without surgery, the disproportions between various body parts will generally persist or increase. Diet and exercise may change body size, but the body shape itself is generally determined by familial traits and sexual (male v. female) characteristics. In some instances direct surgical removal through incisions can also alter body shape. In some patients this may be a better choice than suction lipectomy.
SURGICAL TECHNIQUES/ANESTHESIA/RECOVERY
This procedure can be performed under either a general anesthetic or, if only lower body suctioning is performed, under a regional anesthetic (spinal/epidural). This is a decision which should be made after consultation with both the surgeon and the anesthesiologist. Depending upon the amount of suction to be performed, the procedure may be done as an outpatient or with an overnight stay. In certain patients a “tumescent technique” with preinjection of fluids designed to decrease blood loss and bruising may be used. Multiple, short incisions (1/4-1/2") are placed in normal skin creases to allow access to the area to be suctioned. Through these incisions, suction catheters are passed and the fat accumulations noted preoperatively are reduced. The skin is generally closed with absorbable sutures and supportive steri-strips. A compression garment is placed at the end of the procedure to help control postoperative swelling. It is generally recommended that such a garment be worn day and night for a minimum of two weeks following surgery and during the day for at least an additional two weeks. Some patients find it beneficial to wear the garment for up to six weeks.
Most patients return to work within seven to ten days following surgery. You can expect to resume athletic activity such as treadmill walking or stationary cycling after 3 weeks. It is normal for body tissue fluid and blood to accumulate in the areas from which the fat is removed. This will result in swelling in the areas of suction for weeks to months following the procedure. Consequently, the final result of suction lipectomy may not be totally apparent for three to six months following surgery.
RISKS / COMPLICATIONS
Due to the extensive tunneling necessary to remove the fat cells, significant bruising always accompanies this procedure. It may even extend beyond the areas of fat removal. Temporary, or in rare instances, permanent numbness may occur in the skin overlying the areas of suction. Serious infection is rare, but if it should occur, hospitalization may be required for antibiotic treatment. In rare instances severe infection has led to skin loss in the areas of suction. As noted above, skin dimpling, rippling or other irregularities may result due to poor skin elasticity. Depending on the degree of skin shrinkage and swelling there may be asymmetry between areas of suction. The incisions utilized to insert the suction cannula usually heal well, but will leave small scars. In very rare instances pigmentation changes in the overlying skin may occur.
Depending upon the amount of fat to be removed, blood loss may approach the point where transfusion is required. If this is anticipated, arrangements will be discussed with you prior to surgery to assist you in donating your own blood or in providing banked blood for the time of surgery. In rare patients, respiratory difficulties have occurred due to small amounts of suctioned fat leaking into the blood stream and causing blockages within the pulmonary vessels (pulmonary embolus, fat embolus).
Even though the risks and complications cited above occur infrequently they are the ones that are peculiar to the operation or of greatest concern -- other complications and risks can occur, but are even more uncommon. Any and all of the risks and complications can result in:
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Additional surgery
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Time off work
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Hospitalization
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Expense to you
On occasion, surgical revisions may be indicated following the original surgery. If planned or performed within one year after the original surgery and if insurance does not cover these revisions, there will be no surgeon’s fee charged . Revisions will be done at no charge only to the areas previously treated and only if you are at or below your preoperative weight. Some revisions may be done in our office. If so, a $150.00 fee for supplies will be charged. If the revision must be done in the operating room, the hospital and anesthesiologist will charge a fee to you.
NO GUARANTEE -- The practice of medicine and surgery is not an exact science. Although good results are expected, there cannot be any guarantee nor warranty expressed or implied by anyone as to the results that may be obtained.
COMMENTS
If a smoker -- must be off cigarettes for three weeks before surgery and for three weeks after surgery. There is a much greater risk for scarring, poor healing, hair loss and skin loss in smokers.
Must be off all aspirin containing products for three weeks before surgery and for three weeks after surgery. (Check all medications with us. Some medications such as Motrin and Advil may also affect clotting.)
If there is any item on this consultation sheet that you do not understand, mark it and call the office. An explanation or additional information will be provided. Share the information we provide to you with interested family and/or friends.
Our aesthetic coordinator, Connie Chudoff is available for any questions and can be reached at 609-325-6768.