Dr Tavakoli uses a liposculpture technique pioneered by the Italian plastic surgeon Professor Gasparotti. Suction Assisted Lipectomy (SAL) or liposuction is a surgical technique in which the removal of fat deposits reshapes a specific part of the body, such as the neck, arms, abdomen, hips, or thighs.

FREQUENTLY ASKED QUESTIONS:

What is liposuction?

Liposuction is a surgical technique in which the removal of fat deposits reshapes a specific part of the body, such as the neck, arms, abdomen, hips, or thighs. Liposuction, which was actively practiced in Europe during the mid 1970s, was not popularized in Australia until the mid-1980s. Since then it has become the most requested cosmetic surgical procedure. The popularity of this operation is based on its relative simplicity which requires only a small incision usually well hidden in a normal skin fold. However, to get optimal results the procedure needs to be carried out by an expert plastic surgeon.

What is liposculpture?

Please click here to read Dr Tavakoli's article on superficial liposculpture.

Frequently, patients seek liposuction to reduce their weight and general obesity. Unfortunately, liposculpture is not indicated to treat these problems. Standard methods of weight reduction are required for these patients. Liposuction is intended to re-sculpt isolated collections of body fat that would not generally respond to diet and exercise; it is a method of body contouring to reduce inches, not kilograms. The good news is that the suctioned fat cells are permanently removed. If the patient gains weight later on, the new fat will be distributed in a more proportioned manner.

It is the superficial nature of liposuction that brings change to the deep layer of the skin, leading to controlled skin retraction. This is the key to the eventual success of the procedure.

Who should have liposuction?

Patients with average weight, localized fat collections, and healthy elastic skin are the best candidates for liposuction. Obesity, cellulite, or loose sagging inelastic skin are several problems that would tend toward poor results. In fact, these problems may be worsened by liposuction.

Unfortunately, many individuals performing liposuction are not trained in other techniques of body contouring and may not have the experience to recognize that a different procedure (such as a tummy tuck, thigh lift) may provide a better result for the patient. Hence, Liposuction may be used in conjunction with other body contouring procedures, such as breast reduction, tummy tuck, thigh-lift, or arm lift.

How is the operation performed?

Liposuction can be performed in an outpatient setting ; less frequently a short hospitalization will be required. The procedure can last from 30 minutes to 4 hours depending on how many body areas are being operated upon. The type of anesthesia will also vary. Local anaesthetic with sedation can be used for small areas; however, more extensive procedures usually require general anesthesia. Through a small incision, usually 1-2 cms, a blunt-tipped instrument called a cannula is passed back and forth essentially vacuuming out the fat. The cannula is connected to rubber tubing, which in turn attaches to a machine that generates high vacuum pressure. Following surgery, a firm elasticized garment is used to provide compression and reduce swelling and discoloration at the surgical site. During larger volume surgery, IV fluids are given to replace losses that occur with the procedure. Very rarely, transfusion is required, but this can usually be anticipated prior to surgery so that the patient can receive his/her own blood (autologous donation).

What can I expect after the operation?

As in all operations, pain and discomfort vary greatly from patient to patient. Generally, pain medication would be required for the first several days. Continuing discomfort can last varying amounts of time. Much of the swelling and bruising will be improved by two weeks; however, some will persist for six to eight weeks. It is often difficult to see significant changes in the body shape before this time. It is frequently useful to wear an elastic garment for four to six weeks to help with skin shrinkage. Dr Tavakoli will tell you how long you should wear your elastic garment. Normal activity may be resumed at one to two weeks and exercise at two to four weeks. Persistent swelling and irregularities may be present for several months. If antibiotics are prescribed, they should be taken as directed.

Is hospitalization necessary?

Usually hospitalization is not necessary, but it depends on the volume of liposuction and any other additional surgery. Many of these operations are performed under general anaesthesia and may be done as day procedure.

Is there an age limit for this operation?

People under 40 years of age usually get the very best results because their skin is tighter. However, the state of the skin remains the determining factor, regardless of age.

Are bandages applied?

As discussed earlier, compression garments are worn after the operation to assist in the retraction of the skin and to prevent swelling. Light massage is started on the 10th day. After the operation, exercises are recommended beginning on the 14th day in order to minimize the adhesions between the skin and the deeper tissues. Early results are seen 10-14 days after surgery, but improvement continues for 4-6 months.

When can you return to work?

In general, 3-5 days after the operation for office work, and 14 days for more active employment. This will depend on the amount of liposuction and the type of work.

When can you do exercises?

Usually two weeks after the operation you may exercise in order to modify and diminish the adhesions between the skin and the tissue. Walking, swimming, or a stationary bicycle can usually begin a few days after surgery.

Should you follow a special diet?

In order to have the best results, it is good to have a well-balanced diet, including carbohydrates, fruits, vegetables, and proteins, and not to overeat salty or fatty foods.

When can you get out in the sun again?

When all the bruises have disappeared. This takes about two to three weeks. Use a sunscreen with an SPF of at least 15. Decreased sensation in the first few months after surgery may result in an accidental sunburn.

Are the results permanent?

In general, yes. If you gain weight, however, the operated area will also increase but not as much as would have occurred before the operation. Rippling may also occur with large weight gain.

Weight fluctuations generally will adversely affect the results of liposculpture.

Can the operation be repeated?

Yes, in certain cases.

What about scars?

Following surgery, your surgical scars will go through a maturation process. For the first few months, they will be red and possibly raised, firm, or unsightly. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, "crawling," or other peculiar sensations around the surgical area. This is a result of the healing of tiny fibers which are trapped in the scar. These symptoms will disappear. Some people are prone to keloids which are abnormal scars that become prominent and unsightly with time. If you or a blood relative have a tendency to keloid formation, please inform Dr Tavakoli.

What happens to the excess skin?

Depending upon the age of the patient, the skin (because of its elasticity and retraction) will shrink over the reduced area of the body. Older or excess skin may require subsequent surgery to obtain the desired result. (see abdominoplasty and thigh lift)

It is imperative that all Dr Tavakoli's liposculpture patients consider a course of endermologie after liposculpture.

What is LPG Endermologie?

The LPG® Technique is a non-invasive technique, consisting of a tissue mobilization process between two rollers, creating a skin fold, stretching the underlying tissue and mobilizing the skin fold. The LPG® Technique claims are relief of minor muscle aches and pains, relaxation of muscle spasms and an increase of local blood circulation on healthy as well as burn patients. In addition, LPG's ES Therapeutic Massagers/Vibrators (ES1, ES/M60, Cellu M6) have met all FDA regulatory requirements to be marketed for the temporary reduction in circumferential body measurements, temporary reduction in the appearance of cellulite and relief of Delayed Onset Muscle Soreness (DOMS). In aesthetic field, LPG® Technique is designed by Endermologie® (trade mark). Several studies, both animal and human, have been performed evaluating the efficacy and method of action of the LPG® Technique in various settings revealing multiple points of interest. In an animal study performed on Yucatan pigs (1) it has been found dense collagen bands running parallel to the skin surface deposited at the treatment sites. On human model, Innocenzi showed how trophic is the Technique, either on fibroblasts or cutaneous vessels (2, 3). Other findings of interest include increased blood and lymphatic flow at the treated areas that persist for several hours post treatment session (4). Reductions in body circumference measurements and cellulite grade, regardless of weight loss or gain, have been reported after completion of several treatment sessions (5, 6, 7). In other publications (8, 9) Fodor utilized the LPG® Technique intra-operatively immediately following primary liposuction procedure and reported an impressive reduction of postoperative edema and ecchymosis. In addition, two studies show positive results with the LPG® Technique applied in combination with liposuction (10, 11). Nevertheless, both studies were nonrandomized and used the first generation of Cellu-M6®.

What happens to deep scars that don't respond to Endermologie?

Physiotherapy

Physiotherapist will use a special ultrasound technique for smoothing out any build up of scar in the deep tissue that may occur as a result of the liposculpture procedure.

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