For tumescent liposuction, the most common technique, your doctor will make one or more small (one-quarter inch or less) incisions in the area to be treated and inject a large quantity of a mixture of saline (salt water), local anesthesia, and epinephrine into your tissue. The fluid causes the fat to become swollen, firm, and easier to remove. (It also constricts your blood vessels, which reduces bruising, blood loss, and recovery time.) The surgeon then inserts the cannula through the same incision and passes it back and forth under the skin to break up the fat before suctioning it out. For a very small area, the procedure takes around 30 minutes, while a 360 liposuction—which includes the abdomen, flanks, back, and all around the torso—lasts three to four hours.
Ultrasound-assisted liposuction techniques used in the 1980s and 1990s were associated with cases of tissue damage, usually from excessive exposure to ultrasound energy. Third-generation UAL devices address this problem by using pulsed energy delivery and a specialized probe that allows physicians to safely remove excess fat. UAL is beneficial in people with a particular skin tone, in liposuction of areas that are more difficult to remove fat, that include treatment of gynecomastia, or areas where secondary liposuction is being performed.
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If a man's breasts are enlarged with glandular tissue, liposuction is not an option and other hormonal or medication therapies should be pursued. If the breasts are asymmetrical or oddly shaped, the patient should be examined for possible tumors prior to any surgical intervention. A mammogram is the most effective method for detecting tumors and the possible presence of male breast cancer. After proper testing, a physician can help a patient determine the best course of action.
Liposuction evolved from work in the late 1960s from surgeons in Europe using techniques to cut away fat, which were limited to regions without many blood vessels due to the amount of bleeding the technique caused. In the mid-1970s Arpad and Giorgio Fischer created the technique of using a blunt cannula linked to suction; they used it only to remove fat on the outer thighs. Yves-Gerard Illouz and Fournier extended the Fischers' work to the whole body, which they were able to use by using different sized cannulae. Yves-Gerad Illouz later developed the "wet" technique in which the fat tissue was injected with saline and hyaluronidase, which helped dissolve tissue holding the fat, prior to suctioning. Lidocaine was also added as a local anesthetic. Fournier also advocated using compression after the operation, and travelled and lectured to spread the technique. The Europeans had performed the procedures under general anesthesia; in the 1980s American dermatologists pioneered techniques allowing only local anesthetics to be used. Jeffrey Klein published a method that became known as "tumescent" in which a large volume of very dilute lidocaine, along with epinephrine to help control bleeding via vasoconstriction, and sodium bicarbonate as a buffering agent.
Liposuction will cause some swelling afterwards, although some techniques cause less than others. During follow-up visits with a doctor, it is important for a patient to inform the doctor of any changes in the amount of post-liposuction swelling. Significant increases in swelling can be a warning sign of other complications. Swelling in the ankles and treated areas is common, along with a temporary lumpy appearance that will typically fade within six months. If the thighs are treated, inflammation of the veins may occur, but this should also go away after a few weeks.
No. As a candidate for liposuction, you should be at or near your ideal weight, and you should simply want to enhance your figure and gain a more evenly contoured body. Liposuction is intended to remove isolated pockets of fat that do not respond to dedicated diet and exercise. During this treatment, your doctor should not remove more than 10 pounds or 5 liters of fat. Excess fat removal can result in fluid imbalance and serious complications.
Before exercising after liposuction, patients should consult their surgeons for specific, individual guidelines for liposuction recovery. Most plastic surgeons encourage patients to begin a gentle walking routine within three to four days of their liposuction. Mild exercise protects against the formation of blood clots in the legs and other post-surgical complications.