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Liposuction
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Synonymous to : Laser Liposuction, SMART Lipo, Laser Lipo, Tumescent Liposuction, Liposculpturing
Despite good health and a reasonable level of fitness, some people may still have a body profile with disproportionate contours due to localized fat deposits. These patients are not happy or pleased with their body contour and may have body disproportionality. Our body fat deposits are affected by multiple factors such as changes in hormone level that slows down the body metabolism, stress and psychological behavior that may increase our oral intake of nutrients beyond our need and, genetic characteristics that may predispose us to obesity or being overweight.
Suction-assisted lipectomy, or commonly known as liposuction, is a procedure that slims, reshapes, contours, and restores body proportion thus enhancing the patient’s self-image. Liposuction is a surgical aspiration of the fat under the skin, leaving a more pleasing contour and smooth transition between the regions of the body. Liposuction is one of the most commonly performed cosmetic procedures worldwide by certified cosmetic plastic surgeons.
There are several kinds or techniques to perform a liposuction procedure. The three most commonly performed techniques are the tumescent or superwet liposuction, ultrasound-assisted lipoplasty, and laser or SMART Liposuction. The tumescent or super-wet technique requires an infusion of saline solution mixed with adrenaline to facilitate the aspiration or removal of excess fat. Ultrasound-assisted lipoplasty uses ultrasonic energy that liquefies the fat prior to surgical suctioning. Laser or SMART liposuction, on the other hand, is quite similar with ultrasound-assisted technique wherein fat is initially dissolved and then aspirated. There was a sudden increase in demand for SMART/laser liposuction and ultrasound lipoplasty when they were introduced because they were believed to have more superior results than the traditional method. However, in our experience, the advantage that laser liposuction offers patients in terms of improved pain control after surgery and body swelling is significantly less compared to the traditional tumescent technique. With regards to the result, all the three techniques are just about equal. There is no superiority of one method over the other in attaining a pleasing body contour.
Liposuction is more of an art than just a surgical procedure. It demands a good grasp of anatomy and body proportionality. This is the reason why liposuction is better termed as liposculpturing. The body parts or areas of the body that can be treated by liposuction are the abdomen, flanks or love handle, hips and buttocks, upper and lower back, arms, axilla or armpit (for treatment of hyperhydrosis), thighs and knees, chin, and chest area (especially for gynecomastia). The procedure is done by aspirating the subcutaneous fat with the use of a metal pen like liposuction cannulas through a small skin incision. This small incision is placed at the natural folds of the body so that the resulting scar will be concealed or inconspicuous.
This is performed as an out-patient procedure in a fully-equipped ambulatory surgical facility. However, patients with multiple procedures, or prefer to relax immediately after the surgery, will be admitted for a day or two at a hospital. Whether performed as an out-patient or as a hospital procedure, pre-operative laboratory and medical clearance, especially for patients 40 years old and above with a medical condition that requires treatment, is required. This is done a day before the surgery. The procedure can be performed either under local anesthesia or deep sedation depending on the extent of the procedure. Afterwards, the incision site will soak for two to three days, eventually drying up on the fourth to fifth day. All patients are instructed to strictly apply or wear pressure garments for two to three weeks on all body parts addressed by liposuction. The pressure garment will help the skin redrape to underlying muscles, thus obliterating the space left after aspirating the fat and controlling the swelling. This will assist and enhance the healing process. Sutures are removed on the seventh or ninth day after surgery.
Patients are always advised that there will be swelling and some bruising after the surgery. These are temporary and may resolve after one to two weeks. The initial result may be noted after two to four weeks when much of the swelling had subsided. However, the final result will be appreciated by the second to sixth month after surgery.
Patients planning to have this procedure will be required to allot eight to 14 days for the initial consultation, laboratory, medical clearance, surgery, follow-up, suture removal, and early recuperation. After these, the patient is safe to travel since all wounds are already dry and healed.
Possible risks and complications:
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Tummy Tuck
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Synonymous to : Abdominoplasty
A flat and well-toned abdomen is an appealing body profile or contour which a lot of people aspire to have. We often strive to have this feature through diet and exercise, though they sometimes fail to achieve the goal. Abdominoplasty, or commonly known as tummy tuck, is a surgical procedure that removes the excess skin and fat of the abdomen, and restores or repairs weakened abdominal muscles, to create an abdominal profile that is smoother and firmer. However, patients must be informed that this procedure is not a substitute for diet, weight loss, or an appropriate exercise program.
There are a lot of individuals, particularly women of child-bearing age, who have an abdomen that is protruding and with loose and sagging skin despite having a normal body weight and proportional body profile. These changes in the quality of the skin and abdominal muscles are commonly caused by multiple factors that weaken the structure of the abdominal area. They include pregnancy, aging, massive weight loss, hereditary disorders, and previous abdominal surgery or trauma which may affect or change the strength of the abdominal muscles and lead to laxity of the abdominal wall.
Even though results of this procedure may last for a long time, the positive outcome can be greatly diminished by significant fluctuations in weight that are often accompanied by inelastic and excess skin. This is the reason why individuals who are planning to have substantial weight loss, or women who may be considering future pregnancies, are advised to postpone a tummy tuck surgery.
Tummy tuck is recommended for patients with excess or redundant abdominal skin and/or laxity of the abdominal muscles. This is usually seen among women who had undergone multiple pregnancies, or patients with massive weight loss after bariatric surgery. To be a good candidate for this procedure, patients must be physically healthy with a stable weight, have realistic expectations, don’t smoke, and don’t have any uncontrolled medical illness. The procedure cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised, or generally at those treated areas below the belly button.
Individuals planning to undergo abdominoplasty are prepared prior to scheduled surgery. Two to three weeks before the procedure, patients are advised to avoid smoking; alcoholic beverages; steroids; NSAID’s, or pain medications like mefenamic acid and naproxen; herbal tea and herbal medications; vitamin E; blood-thinning medications like aspirin, heparin, and coumadin; regulated drugs like Valium; prohibited drugs like methamphetamines; diet pills; and oral contraceptive pills. These medications and social activities may delay healing, prolong bleeding during surgery, and may interact with the medications used during the procedure. Patients are advised to discuss this further with their surgeon to minimize possible risks and complications.
The surgery is performed either under sedation, or using regional or general anesthesia depending on the extent of the procedure. This can be performed in an out-patient surgical facility that is accredited by the local health department, or the patient may be admitted to a hospital for a few days. A full tummy tuck procedure requires a horizontally oriented incision, located at the lower abdomen just above the pubic hair line, which may extend from hip to hip depending on the amount of excess abdominal skin that needs to be removed. Through this incision, a large area of the lower abdomen’s skin and fat is removed. The weakened abdominal wall muscles are repaired with non-absorbable plication sutures. This will tighten the abdominal wall and improve abdominal tone and contour.
After abdominoplasty, the abdomen will be flat and firm and be more proportionate to the patient’s body contour. The initial results after the surgery may be obscured by swelling and some bruising. These are temporary and may resolve after one to two weeks. Patients are advised that the final outcome will be evident after three to six months.
Pressure garments or abdominal binders are applied for two to three weeks on the abdomen after surgery. This will help the skin redrape to the muscles and control the swelling. Sutures are usually removed ten days after surgery.
Prospective patients planning to have this procedure are required to allot 12 to 14 days. This time will be used for the initial consultation, laboratory, medical clearance, surgery, follow-up, suture removal, and early recuperation. After these, the patient is safe to travel since wounds are dry and healed.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo including the risks and potential complications.
Possible risks and complications include:
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Buttocks Augmentation
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Synonymous to: Gluteal Augmentation, Buttocks Enhancement or Surgery
The gluteal area is one of the most commonly enhanced areas of the body next to the breast. Gluteal fullness, with smooth sloping contour is ideal and pleasing to the eye. The gluteal contour and volume is best enhanced by a butt augmentation procedure. The procedure would result in a round, more firmly shaped buttock area. Gluteal augmentation can be performed with the use of gluteal implant to improve gluteal size and contour. Patients who frequently request for a gluteal or buttock augmentation procedure are those with a butt that has inadequate volume and a flat contour. This procedure is not ideal for a patient who has sagging gluteal skin, which is best addressed by a butt lift surgery.
Gluteal implants, or commonly referred to as buttock or butt implants, are either a soft or solid silicone block or silicone shell containing cohesive silicone gel. Both types of implant are safe. They do not cause any allergic or toxic reaction to the body, can be sterilized, do not induce any soft tissue disease or malignant transformation, and can be removed easily when indicated. These implants are often used for augmentation or enlargement surgery of the buttock region and occasionally for gluteal reconstruction in treatment of asymmetry. Implants are placed in a pocket created either beneath the fascial covering of the gluteal muscle or within the muscle. Both implantation sites are well tolerated by the body and have very predictable and pleasing outcome or results.
Another method that is used to augment the gluteal area is by fat injection. This is ideally performed for patients who have hesitation in having a foreign material (buttock implant) in their body; or those who have unsightly or unwanted fat deposits at the abdomen, thighs, or arms requiring liposuction. The fat is initially harvested by gentle liposuction technique and then processed into pure form. The pure fat is then injected to the gluteal muscle through a very small port-like incision. For better fat survival, and to minimize fat resorption by the body, the harvested fat is transplanted or injected to the gluteal muscle. This improved fat survival is due to the improved blood supply to the fat cells when injected into the muscle.
Individuals planning to undergo buttock augmentation are prepared prior to the scheduled surgery. For two to three weeks prior to to the procedure, patients are advised to avoid smoking; alcoholic beverages; steroids; NSAID’s, or pain medications like mefenamic acid and naproxen; herbal tea and herbal medications; vitamin E; blood-thinning medications like aspirin, heparin, and coumadin; regulated drugs like Valium; prohibited drugs like methamphetamines; diet pills; and oral contraceptive pills. These medications and social activities may delay healing, or they can prolong bleeding and interact with the medications used during surgery. Patients are advised to discuss this further with their surgeon to minimize possible risks and complications.
Gluteal augmentation is performed either under regional or general anesthesia depending on the techniques and extent of the procedure. It is best that patients are admitted for a minimum of one to two days after surgery for more comfort and better pain management. All patients undergoing general anesthesia are required to have a pre-operative medical evaluation and laboratory tests to assess their general medical condition. With the patient asleep under general anesthesia, a two to three-inch incision is made at the fold between the buttocks at the midline. Through this incision, the gluteal muscle is lifted and a pocket is created just large enough for the implant. The implant is then inserted into its pocket. Absorbable sutures are placed in the skin incision. A pressure dressing or bandage is placed to provide compression to the buttocks and hold the implant in place. This will also help reduce discomfort and swelling after surgery. Sutures are usually removed after seven to ten days.
Because we often use the gluteal muscle in numerous physical activities like walking, sitting, and other movements, patients might experience greater pain during the recovery period than other common cosmetic surgery procedures, and the recovery time is usually longer. Pain medications typically are prescribed to help with the discomfort; but after approximately five to seven days, the patient is able to be up and about – moving, walking, and sitting more comfortably. Full activities including gym work, bicycling, and running can usually be resumed about four weeks following buttock augmentation. The gluteal area will have fullness, especially at the upper pole, and will look firmer. The initial results after the surgery may be obscured by swelling and some bruising. This is temporary and may resolve after two to four weeks, but patients are advised that the final outcome will be evident after six to eight months. Prospective patients planning to have this procedure are required to allot 12 to 14 days. This time will be used for the initial consultation, laboratory, medical clearance, surgery, follow-up, suture removal, and early recuperation. After these, the patient is safe to travel since wounds are dry and healed. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, including any risks or potential complications.
Possible risks and complications include:
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Buttocks Lift Surgery
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Skin laxity is the defining characteristic of patients who are candidates for buttocks lift. It could be caused by genetics, although it is more frequently seen in patients who have gained and lost an excessive amount of weight. Usually done with other procedures such as thigh lift or abdominoplasty, buttocks lift involves the removal of excess skin and fat at the thigh and lower back area, resulting in tighter skin of the gluteal region which creates an improved, more rounded, firmly shaped and toned butt and thigh contour. There could be some swelling immediately after the operation, but it usually subsides after several weeks to months. Sutures are removed on the fifth or tenth day after the procedure. This is done under general or regional anesthesia, with the patient confined for a few days in the hospital.
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Arm Lift
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Arm tissue relaxes with age, gravity, and weight loss. The drooping of the skin is due to the stretching of the anchoring system of the arm and the loss of supporting fat volume. Brachioplasty (arm reduction surgery) can remove excess tissue and reduce the circumference of the upper arm. Surgical correction depends on the amount of extra skin and how loose the supporting tissues have become. Extra skin is removed from incisions along the inner arm. The incision must be placed where the tissue can be best tightened, but the incision must be well hidden as well. There could be some swelling immediately after the operation, but it usually subsides after several weeks to months. Elevation of the arm regions with pillows increases comfort. This is done under general anesthesia, with hospital admission for a few days. Sutures are removed on the fifth or tenth day after the procedure.
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Thigh Lift
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A thigh lift is done to remove excess skin from the thigh and up to the buttocks area. This sagging skin is usually caused by weight loss and/or ageing. The inner thigh lifts are done with incisions over the inner thigh which are hidden in the groin crease. Outer thigh and buttock lifts are done with incisions extending from the groin around the back, and they could be done with a buttocks lift surgery. The scar from surgical incisions is well hidden by bathing suits or clothing. All of the scars fade with time. Bruising and swelling are to be expected, as well as a “tight” feeling in the thighs. This usually subsides after several weeks. This is usually done under general anesthesia with the patient confined for two to three days. Suture will be removed after ten to 14 days.
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