Dermatologic & Cosmetic Surgery

Dermatologic Treatments

Liposuction

Liposuction is most effective for removing localized fat deposits in body areas that do not respond to dieting or exercising. Liposuction is not intended as a substitute for weight loss, but rather is a contouring procedure. It is best utilized in a program of exercise and optimal weight maintenance.

Liposuction is a safe, effective procedure when it is done conservatively and without heavy sedation. In all of the recent cases in the press in which there was a complication associated with liposuction, the patient was "put to sleep" for the procedure.

Liposuction also has many valuable therapeutic applications and has been used effectively to treat medical conditions like non-cosmetic fat accumulation, such as lipomas (benign fatty tumors) and gynecomastia (enlarged, male breasts)

Lipomas, composed of mature fat cells, are benign tumors which grow under the skin and typically appear as round or oval lumps with no change to the skin color and texture of the area. While they may occur anywhere, they typically appear on the neck, trunk, abdomen, and forearms. Removal is usually recommended if it is causing pain, pressure, irritation, or is growing. Patients also may choose to have it removed for cosmetic reasons.

Often, if the lipoma appears large and diffuse, liposuction can be performed and results in less scarring. When liposuction of the lipoma is not an option, a surgical excision is recommended.

BENEFITS
Removal of unwanted fat deposits

WHAT IS LIPOSUCTION?
Liposuction is the removal of excess fat with a small, straw-like instrument called a cannula that is attached to a suction machine. The fat layer under the skin is converted to a network of tunnels, and the cannula is manipulated within the layers to remove unwanted fatty deposits. An elastic garment is then worn for compression and healing. The result is a resculpting of bulging areas into more attractive contours.

WHAT IS THE TUMESCENT TECHNIQUE?
Liposuction was first developed in the late 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. Developed by dermatologic surgeons in the 1980s, a major advancement called the tumescent technique of liposuction completely revolutionized the procedure. The use of tumescent liposuction allows dermatologic surgeons to safely and effectively remove deep and superficial layers of fat under local anesthesia with relatively little discomfort, virtually no complications and improved cosmetic results.

WHAT AREAS CAN BE DONE?
Abdomen, hips, flanks, inner and outer thighs, knees, neck, arms, back, ankles, calves.

IS IT BETTER TO BE ASLEEP FOR LIPOSUCTION SO THE PROCEDURE WILL BE MORE TOLERABLE?
No. Liposuction is easily tolerated with local tumescent anesthesia. Anesthesia is the biggest risk factor for any surgical procedure, so eliminating the general anesthesia eliminates the largest source of complications.

IS LIPOSUCTION CONSIDERED TO BE RADICAL, MAJOR SURGERY?
No. Liposuction is the most common cosmetic procedure done in the United States. Most people come in for one or two problem areas that are easily taken care of with a local anesthetic. These people have a figure problem that has often bothered them since adolescence. Common complaints we hear from women: "I've never been able to wear a straight skirt because of the lumps on my outer thighs." "The excess fat in my lower abdomen and hips makes my clothes uncomfortable around my waist." "I never wear sleeveless shirts because of the fat on my upper arms." From men: "No matter how I work out, I always have love handles." "The fat in my chest makes me look like I have breasts."

WHAT HAPPENS IF I REGAIN WEIGHT AFTER LIPOSUCTION? WILL THE FAT COLLECT IN ODD PLACES?
Most people who regain weight after liposuction say the fat distributes more evenly (less preferentially to their problem area). Still, we prefer to choose candidates who have a stable weight pattern, and who don't experience large fluctuations of their weight as they will have the best long-term result.

WHAT IS DONE BEFORE LIPOSUCTION?
Before surgery, a complete medical history is taken and a careful examination is conducted in order to evaluate your condition. During the consultation, your dermatologic surgeon describes the procedure and what results might realistically be expected. Dr. Lawrence also will review alternative treatment options and explain the possible risks and complications that may occur. Photographs are frequently taken before and after surgery to help evaluate the amount of improvement. Blood work required, measurements for girdle, antibiotic.

HOW IS TUMESCENT TECHNIQUE OF LIPOSUCTION PERFORMED?
Liposuction can be performed in Dr. Lawrence's office. We use local anesthesia (often used with light sedation) via the tumescent technique. This breakthrough technique refers to the swelling of the skin with local anesthetic in order to remove unwanted fat more efficiently.

With tumescent liposuction, large volumes of a solution containing dilute lidocaine ( a local anesthetic) and dilute epinephrine (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, a small incision is made into the skin, and a tube connected to a vacuum is inserted into the fatty layer. Using to and fro movements, the fate is drawn through the tube into a collection system. The tumescent method enables the dermatologic surgeon to remove large amounts of fat more uniformly with fewer skin irregularities and less bleeding and bruising.

WHAT HAPPENS AFTER SURGERY?
The local anesthesia injected into the tissue remains for 18 to 24 hours following liposuction surgery, greatly minimizing post-operative pain. After tumescent liposuction, patients are usually alert and able to function without nausea, grogginess and the "washed out" feeling associated with general anesthesia. With the tumescent technique, there is minimal bruising, and many patients do not require post-operative medication for pain. You can usually return to a desk-type job within 48 hours; physical exercise generally can be resumed 3 to 7 days after liposuction.

ARE THERE LIMITATIONS TO LIPOSUCTION?
Liposuction is not intended as a method for weight loss. It is used as a shaping procedure for areas where hereditary fat deposits resistant to diet and exercise have accumulated. The best results from liposuction occur in body areas where there is reasonable muscle tone, where skin has good elastic quality, and where fat is not excessive. In cases where there is a significant loss of tone and elasticity, superior cosmetic results may require a combination of both liposuction and surgical skin tightening to remove the excessive loose tissue.

Dr. Lawrence can advise you of the likelihood of the need for additional treatments, depending on the specific condition of your skin.

ARE THERE ANY POSSIBLE COMPLICATIONS?
As with any surgery procedure, the risk of complications cannot be eliminated, but can be minimized. Dr. Lawrence has recently completed a national liposuction outcome study in conjunction with the Wake Forest University School of Medicine, Department of Dermatology and Public Health Science. In this study, 63,490 cases done by dermatologic surgeons across the country over a 7 year period were reviewed with no reported deaths. The study confirms the safety of tumescent technique liposuction.

Get more information at the resources below:
CLICK HERE to visit the American Society for Dermatologic Surgery

PRE & POST OPERATIVE LIPOSUCTION PHOTOS

PRE-OP PHOTOS	POST-OP PHOTOS

To make an appointment with a Cooper University Hospital physician at an office near you, call 1-800-8-COOPER (800-826-6737) to speak with a member of our physician referral and information service.