Liposuction
has become the most commonly performed cosmetic
surgery procedure world – wide. There is a rising
trend towards larger volume liposuction. Increasing
number of “over weight” people, rising awareness
levels, peer pressure to look good and increase
in safety profile of
liposuction have contributed
to the rise in number of
cosmetic surgeries performed
and larger volumes being aspirated.
Aspiration
of more than ten liters of fat in one sitting
is termed mega liposuction. The proportion of
mega liposuctions being performed is increasing
world – wide as more and more surgeons get convinced
of its safety. Up to 20 liters can be aspirated
in one sitting in well – selected cases and
in a hospital setting with good infrastructure.
Mega liposuction is probably better done under
GA as most of there cases require circumferential
liposuction.
Liposuction
is not meant for weight loss, the primary aim
is body contouring. When large volumes of fat
get aspirated, amount of weight loss also happens.
The more elastic the skin, better the liposuction
results.
Liposuction
is not a substitute for a poor lifestyle – maintaining
the results requires regular exercises and calorie
restricted diet. Liposuction removes most of
the fat cells on the areas treated, hence the
chance of putting on weight in these areas get
reduced.
Volume
reduction of the subcutaneous fat is followed
by healing and readjustment of the skin to the
new contour. However, if you have flabby skin
as a result of pregnancy or sudden weight loss,
the skin will become more sagging after liposuction.
Such cases require a “lift\ tuck” procedure
in addition
Mega
liposuction can be safely performed by an experienced
surgeon and anesthetist. Standard risks of anesthesia
exist when the procedure is done under General
Anesthesia. As liposuction removes fat under
the skin only, without damage to internal organs,
there are no long term health risks.
As
most of the mega liposuctions are performed
under General Anesthesia, monitored anesthesia
is essential. General Anesthesia offers maximum
comfort to the patient as circumferential contouring
of back, front and sides can be performed without
subjecting patients to inconvenient positions.
It
is important that such surgeries be performed
at a good surgical facility with all supportive
measures and back up facilities. This clearly
is not a surgery to be undertaken in small clinics
or nursing homes.
Bruising,
swelling and soreness are to be expected post
procedure. These are temporary effects of surgery
and are expected to resolve in 3-4 weeks. Major
risks include pulmonary edema, hemorrhage, and
toxicity from local anesthetic. There are fortunately
rare. Patients who are high – risk for pulmonary
embolism need appropriate preventive measures.
Small
diameter canulas have improved results in liposuction.
There is less chance of contour irregularities
and of damage to blood vessels and nerves.
Also
the size of access points can be reduced with
finer canula. Ultrasound assisted liposuction
(UAL) and power assisted liposuction (PAL) have
reduced surgeons work effort. These new techniques
are advantageous on scarred areas and in secondary
liposuctions.
Although
newer instruments have certain advantages to
them, ultimately the quality of result is dependent
on the skills of the surgeon.
