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Most people, no matter how fit and healthy, have areas of extra fat on the body that they do not like. In men it is the waist area, and in women the tummy, hips and thighs. Many of us have often thought that it would be nice to have liposuction to remove the excess fat and start over again by watching our diet and exercising. However traditional old time liposuction is a traumatic surgical procedure which is painful and with a prolonged recovery. Worse, a large percentage of people who have old time liposuction end up with lumps bumps, divots and irregularities on the skin after liposuction.
I have been using tumescent laser liposuction with the new SlimLipo laser lipo technique for almost a year now and I am amazed at how much better the tumescent laser liposuction technique is than the old time non-laser liposuction method. My patients have smooth tight skin after laser liposuction, and their recovery after laser lipo is much easier and less painful.
The benefit of the new tumescent laser liposuction technique is that the laser melts the fat before it is removed, making fat removal much easier with laser lipo. The tumescent technique minimizes bleeding and discomfort. The laser also tightens the skin as the fat is melted. The result is more uniform fat removal, smooth skin, less bleeding and less pain after tumescent laser liposuction.
What Is Tumescent Laser Liposuction?
Tumescent laser liposuction is a new liposuction method that combines the use of tumescent solution with laser melting of fat before fat removal. Tumescent solution is a liquid that contains an anesthetic or numbing solution and a vasoconstrictor, a medication that helps control bleeding. The tumescent solution is injected beneath the skin, into the fat to be removed, before the laser liposuction or laser lipo is started.
The tumescent solution numbs the skin area for pain control which can last up to 24 hours. The solution also prevents bleeding which reduces post laser liposuction bruising and swelling, which speeds recovery.
The tumescent solution is injected under pressure, which swells or distends the fat and makes removal easier. The distention and hydration (adding water to) of the fat also improves the effectiveness and safety of the laser treatment to dissolve the fat.
The benefits of the tumescent laser liposuction technique are
- Excellent pain control
- Less bleeding and bruising
- More effective fat removal
- Less risk of skin irregularities after liposuction
How Is the Tumescent Laser Liposuction Treatment Done?
Tumescent laser liposuction may be done with you awake or asleep. Many areas can be treated with you awake using only the local anesthesia provided by the tumescent solution. However, the benefits of tumescence are so important that tumescent solution is also used when laser liposuction is done under general anesthesia, for control of bleeding, improved fat removal and for post operative pain management.
After your skin has been cleansed with a sterile anti-bacterial soap, the skin area to be liposuctioned is sterilely draped to prevent contamination. Tiny punctures are made in hidden areas of the skin, and a small needle inserted beneath the skin into the fat to be removed. The tumescent solution is then injected into the fat under pressure to swell the fat and deliver the anesthetic and vasoconstrictor (prevents bleeding) solution.
After a brief waiting period until your skin is numb and the tumescent fluid has taken effect, the laser fiber is inserted through the same puncture sites and the fat is melted with the laser. The fat is liquefied into a thin liquid which is much easier to remove than fat that is removed with traditional old time liposuction.
After the fat has been liquefied, a small tube called a cannula is inserted and the liquid fat removed by suction. Because the fat has been liquefied, much smaller cannulas can be used than with traditional non-laser liposuction. This fact results in a less traumatic procedure with tiny hidden scars, very different from old time liposuction.
The laser also tightens the skin as the fat is lased. The laser heats the fibers that attach your skin to your body, and causes these fibers to shorten which pulls the skin closer to the body. Microscopic studies have shown that many more fibers, called connective tissue, are left after laser liposuction than after non-laser liposuction. I believe that this fact helps explain the improved skin tightening and smooth skin after laser liposuction.
How Will I Feel After Surgery?
Because the new technique places numbing solution in the liposuction area, you will have very little discomfort immediately after and up to 12 hours after your procedure. In addition you will be given strong pain killers to manage any discomfort.
The second day you will feel discomfort in the treated areas, however in my experience, the level of discomfort is certainly much less than that experienced with traditional non-laser surgery. By day 3 most patients are very comfortable.
You will be wearing a supportive compression garment on the treated areas which adds additional support and comfort.
You will be up and around, able to eat, walk, use the bathroom and do normal daily activities the day after your procedure. I recommend that you not go to the gym or do vigorous physical activity for the first week to ten days because I want the healing process to be undisturbed during this time.
How Long Is the Recovery?
You will be active and walking from day one. However I will limit your vigorous exercise and weight lifting or aerobics for ten days.
Your garment will be changed to a light Spanks type garment after three to five days. If small sutures are used to close the small puncture sites they will be removed at day five.
When small areas like the chin or a minor tummy procedure are done, some people return to work the next day. I do not recommend returning to work the same day-I want you to be quiet and rest the first day.
Recovery to a more normal skin appearance can take ten days to two weeks for swelling and bruising, if any, to resolve.
Your skin appearance, skin tightening and result will continue to improve for three to six months as the skin gradually tightens over the areas where fat has been removed. The remarkable thing about the this new technique technique is that the skin is much smoother than after traditional old time suction lipectomy. I believe that the laser dissolving of the fat prior to removal results in a more uniform fat removal.
Which Laser is best?
I use the SlimLipo Aspire system made by Palomar Medical. I have chosen this laser because the SlimLipo uses the only laser wavelength which is specifically absorbed by fat. The SlimLipo uses a 924nm (nm=nanometers, one millionth of a meter and describes the wavelength of the laser color in the visible light spectrum, which for 924nm is yellow, the color of fat) laser wavelength.
The 924nm laser wavelength used in SlimLipo dissolves or releases three to five times as much fat during lasing as do the other commonly used wavelengths. The other wavelengths used by different machines target water, not fat, and are less efficient and less specific at fat dissolving.
The 924nm SlimLipo also works very well in hydrated fat, meaning that fat dissolving with the laser works very well after the tumescent fluid has been injected.
How Do I Find a Surgeon?
I am a board certified plastic surgeon, thus I am very prejudiced that you should have your procedure performed by a board certified plastic surgeon. My view is that if you are going to have surgery of any kind, you want a board certified surgeon who has been fully trained and is expert at taking care of a surgical patient. You want the safety of knowing that if something goes wrong, your doctor will have the skill, experience and training to take care of you.
Many dermatologists do liposuction. If you wish to have a dermatologist do your procedure, I recommend that you make certain that your dermatologist is board certified and has had a fellowship in dermatologic surgery.
I recommend that you visit the following sites to learn more about liposuction surgery and how to check out your doctors training, experience and board certification status:
American Board of Plastic Surgery
American Society of Plastic Surgeons
American Society of Aesthetic Plastic Surgeons
What Questions Should I Ask the Doctor?
Do not be intimidated by the white coat and afraid to ask the doctor important questions. You are an educated consumer, and a good doctor will welcome the fact that you are prepared and have done your reading. I prefer to have informed patients, they always do better after surgery. Plastic surgery is no place for snap decisions or impulse buying.
In my book Save Your Face, in Chapter ten, I give details on how to choose your doctor and what questions to ask. A brief summary of important questions are:
o Are you certified by the American Board of Plastic Surgery?
o How often do you do this procedure?
o Do you think I am a good candidate for this procedure?
o Are you comfortable operating on me with my particular goals?
o Do you anticipate a good result-why?
o Can you show me before and after picture of patients that you have operated on?
o Can I speak to a patient who has had this surgery by you?
o What are the arrangements for an emergency during nights and weekends-are you available?
o Will my procedure be done in an approved operating room or outpatient facility under standard sterile and safety precautions? Are emergency services and monitoring available if needed?
Most importantly, trust your gut feelings during your visit with the doctor. Is the office clean and professional? Do the doctor and staff treat you in a respectful manner? Ask yourself will I be comfortable calling these people and depending on them if I have an emergency at night or on weekends? Will I be comfortable expressing my concerns or disappointment if I feel that way? If you detect any discomfort or uncertainty, you should consult another doctor.
This new laser procedure is a remarkable, revolutionary advance in liposuction and fat removal techniques. The benefits can be very significant. However, the results of liposuction, like any surgical procedure are very dependent upon the skill and expertise of your surgeon. Choose wisely and I expect that you will have a very happy result.
Brooke R. Seckel, M.D., FACS