Surgical Procedures

 
 
   

Liposuction

No matter how many miles, sit-ups, weights or laps I do, the fat remains."

 

 

The fact is, certain areas of fat in your body are immune to exercise.

 

But you can remove fat accumulations permanently with liposuction.

 

The removal of fat deposits from specific areas of the body is the most popular and fastest-growing cosmetic surgery procedure in North America. Liposuction can remove stubborn areas of fat that refuse to respond to traditional exercise and diets.

 

Body shape and fat distribution is determined by hereditary, gender and general fitness level. These are factors that are not entirely under our control. We all know of people, who are in excellent condition, exercise regularly and yet cannot get rid of fatty deposits of the upper, outer legs, knees and hips. These areas and the lower abdominal area are particular trouble spots for women. Men have other areas of fat deposition, typically around the flanks. These areas generally respond very well to liposuction treatment. Liposuction is by far the commonest body contouring procedure carried out. It is the procedure of choice for reshaping fatty contours.

 

Although liposuction can never be a substitute for exercise and dieting, it can remove stubborn areas of fat that refuse to respond to traditional exercise and diets. Liposuction is often used for large, oversized hips, buttocks, thighs, bellies and "love handles" as well as fat deposits on arms, calves, knees, ankles, above the breasts and under the chin. Different areas can usually be treated during a single operation.

 

Liposuction techniques have improved tremendously since its' introduction to North America in the early 1980's by the French Plastic Surgeon Dr. G. Illouz. Improvements include the use of specialized fluid injections into the area to be treated (Tumescent Liposuction), smaller, finer instruments (Liposculpture) and the more recent introduction of Ultrasonic Assisted Liposuction (UAL) and Power Assisted Liposuction (PAL). Certain body areas respond better to one technique than to another. The Centre has available all the latest equipment including the Mentor Contour Genesis® UAL equipment so that every procedure can be customized to the patient's area of concern.

 

The most recent technologies used for "liposuction" don't actually suction any fat at all.

 

These include "laser liposuction"  i.e. SmartLipoTM and external ultrasonic liposuction i.e.  UltraContourTM and UltraShapeTM.

SmartLipoTM uses a laser  threaded through a tiny incision to melt fat cells. This does require local anesthetic at a minimum. It is slow. All body areas can be treated.

 

UltraContourTM and UltraShapeTM are types of HIFU (High Frequency Ultrasound) technologies. They use focused sound beams to rupture fat cells. There is no anesthetic required and there is little if any downtime. Multiple sessions( 2-5)  are required typically at monthly intervals. Not all body areas can be treated with HIFU.

 

The concern with all these techniques is this: where does the content (fat, lipids, triglycerides) of the ruptured fat cells go?

 

Normally these products would be returned to the liver and then distributed to surviving fat cells resulting in a net increase in fat cell size possibly in  a different area. This is not an issue with conventional liposuction as the fat is physically removed from the body.

 

These technologies are being followed closely by us and will be available when proven safe and truly effective.

 

How Liposuction Works 
The goal of all liposuction procedures is to safely and permanently remove subcutaneous excess fat and thereby improve body contours. Over the past ten years, liposuction has seen a variety of improvements and refinements. The new techniques today include the tumescent technique and Ultrasound Assisted Lipoplasty (UAL)and Power Assisted Liposuction ( PAL). All of these procedures can deliver much more precise results than conventional liposuction.  

 

Recovery times depend on the amount of fat removed regardless of technology used.

 

Conventional liposuction does this with a stainless steel tube (cannula) that is inserted under the skin and into the deepest parts of the fatty deposits. The back and forth movement causes the mechanical breakup of the fat cells. A vacuum is applied to the cannula and the fat cells and contents  are suctioned out and removed. This produces channels or voids in the remaining fat under the skin. These empty spaces progressively collapse and shrink over the following three to four months. This shrinkage is hastened by the use of a compressive girdle. This garment is worn for three weeks following your procedure. The final appearance of the treated area depends on the amount of fat removed and the ability of the skin to shrink and redistribute itself. Poor skin cannot shrink and although the bulk of the treated area will be reduced, the appearance can be unsatisfactory. Although certain body areas are more favorable than others, it takes experience to judge who will benefit and who will not. Conventional liposuction using tumescent infiltration is useful in most body areas. The term "Liposculpture" simply means the use of a very fine cannula to treat the neck and face.

 

 

The most significant improvement in liposuction has been the introduction of the Tumescent Technique.

 

The tumescent technique involves the injection of a fluid containing epinephrine, local anaesthetic and intravenous fluid into the area to be treated. The amount of fluid injected is equal to the amount of fat to be removed. The advantage is increased patient safety because of decreased blood loss. Discomfort and bruising are also reduced.

 

Ultrasonic Assisted Liposuction (UAL) removes fat cells using high frequency sound waves. This is internal high frequency ultrasonic  liposuction. A probe similar to that used for conventional liposuction is placed into the fatty area to be treated. The tip generates sound waves that disrupt the fat cells making them easier to remove. UAL is particularly useful for the back, "love handles", male breast and the upper abdomen. These are areas that have more fibrous tissue surrounding the fat. UAL is always done using tumescent infiltration.

 

Power Assisted Liposuction (PAL) uses a powered cannula to produce a reciprocating movement that reduces the effort required to break up fat cells. This results in less operator fatigue and more control.

 

Regardless of the technique used all liposuction depends on the destruction of fat cells followed by skin shrinkage.

 

No available technology can reliably cause skin to shrink.

 

Liposuction works best on people of relatively normal weight with relatively firm, elastic skin, who are bothered by pockets of excess fat in certain areas. Patients should be healthy, emotionally stable and realistic in their expectations. Age is not a major consideration but older patients who usually have diminished skin elasticity will probably not achieve the same results as younger patients with tighter skin.

Despite early expectations, Liposuction has no effect on cellulite.

 

Liposuction does not improve or worsen the appearance of cellulite.

 

 

Successful Liposuction depends on the Following Elements:

 

External Fatty Deposits 
Fatty areas that can be pinched or held between the fingers. Fat inside the body wall cannot be treated with liposuction. Males typically have more inside the body wall while women have more outside. Women are generally better candidates for liposuction than men.  Fat in different body areas respond differently to liposuction. Experience allows Dr. Weiglein to customize the procedure to your specific needs by using the appropriate combination of methods whether it is liposculpture, conventional liposuction or UAL or PAL.

 

Good Quality, Elastic Skin 
A good result depends on the ability of the skin to shrink and redistribute itself after the fat has been removed. This typically takes three or more months to happen. Thin, stretch-marked or inelastic skin will not shrink and the final cosmetic appearance will be poor. The quality of the skin varies throughout the body and therefore some areas are more favorable for liposuction than others.

 

"Favorable" areas are the back, lateral legs, medial knees and abdomen in men  and women with no pregnancies. "Unfavorable" areas are the upper arms, upper medial thighs, necks and any stretch marked or lax skin. We will not  offer the procedure in unfavorable areas.  An assessment of the area of concern is required to determine it's suitability for liposuction.

 

Safe Anaesthesia 
Liposuction requires some form of anesthesia. The Centre offers all types of anesthesia up to and including complete general anesthesia. A qualified, experienced Anesthetist monitors all patients. Promises of "local" anaesthesia only to carry out this procedure are misleading and potentially dangerous. Dr. Weiglein will discuss your needs regarding anaesthesia.

 

A Qualified, Experienced Plastic Surgeon 
You have little control over the quality of our skin or the location of the fatty deposits, but you can decide who performs your liposuction procedure. Liposuction is normally safe, if the operating facility is properly equipped and accredited, the doctor is trained and experienced, and the patients properly selected. Your surgeon should have at least a basic, accredited surgical training with additional training in body contouring. These days, there are lots of different kinds of doctors who are performing liposuction - general practitioners, gynecologists dermatologists- without any recognized training in the technique. That's because there are no federal or provincial regulations governing the scope or quality of education a physician must attain before doing liposuction. It's our opinion that non surgeons should not be doing surgery.

 

The most significant factor in obtaining a good result is the surgeons' experience.

 

Liposuction is a surgical procedure and, as with any other surgical procedure, the results are far better when carried out by an experienced surgeon. Dr. Weiglein studied with Dr. G. Illouz,  a French plastic surgeon and the inventor of Liposuction, in Mexico City in the early 1980's. Dr. Weiglein carried out the region's first Liposuction procedure in 1984.

 

 

Liposuction only treats excess fat. For some individuals other surgical body contouring procedures such as an Abdominoplasty may be a better alternative. Dr. Weiglein can advise you regarding the best way to improve your figure.

 

Questions about:

General anesthesia is required for the procedure. If you are not healthy enough for an anesthetic we will not proceed. Anesthesia standards require that you are seen by an appropriate medical doctor prior to the procedure. All of our anesthetists are fully trained and certified.

Bleeding can occur after any operation. If it happens it will occur within the first 24 hrs. It is important to stop taking any medication (aspirin!) or supplements ( green tea!) at least 10 days prior to any surgical procedure as many of these products act as blood thinners. Bleeding is very rare following our liposuction procedures. There is usually no external bleeding but there may be more bruising than normal.

Fluid shifts result from the controlled injury caused by any form liposuction. Large fluid shifts can cause significant loss of blood pressure. Large fluid shifts are caused by excessively large procedures, failure to adequately replace fluids during and after the procedure. We prevent this problem with careful intra venous fluid management during and after the procedure as well as sensible limits on the volumes of fat removed at any one procedure.

Infection can occur after any operation. A surgically clean environment, careful surgical technique, healthy patients and suitable antibiotic coverage will minimize the risk of infection. Infection is very rare following liposuction.

Scars can result from the very small holes required to insert the cannulas.  These are usually not an issue as they usually fade well. Liposuction cannulas are between 2 -5 mm in diameter and therefore cannot be very long as they may break. This may require more insertion holes to effectively treat the area of concern. We work hard to give you the very best outcome.

Pain requiring more than routine medications is very uncommon. The discomfort associated with liposuction is more dull , bruise like. It is usually gone within a few days.

Blood clots can form in the deep (not varicose) veins of the legs and pelvis during any operation. This is called a deep vein thrombosis (DVT). It occurs 72-96 hours after the operation when you are at home and may be asymptomatic. This is very rare  with liposuction. At the Centre we use all known methods to decrease this unusual problem to its absolute minimum.

Contour irregularities following liposuction are rare in our practice although unfortunately we still see them in patients treated elsewhere. They are caused by overall excessive removal of fat or removal of fat from directly beneath the skin. They are generally not possible to resolve.   

From Initial Phone call to Post Op Visits: How it Works

Your initial contact with the office will be with Trish, our Patient Coordinator. She will guide you through the process. You will then meet with Dr. Weiglein to determine the best solution to your particular problem. This initial meeting is designed to be an information and educational meeting. It is actually a time when you "audition" us and we "audition" you. With your input a recommendation will be made and all questions answered. We have numerous pre and post operative photos for you to see. There are always former patients available to speak with you about their experience. We welcome friends / husbands/ others to this meeting.

You will then meet with Trish again to discuss costs, scheduling and logistics. If you require more time to consider your options, or wish another appointment, we will arrange it. If you wish to finance the procedure we will assist you.

We encourage you to see us as a second opinion.

If you elect to proceed you will then meet with one of our nurses for your pre operative visit. She will review the procedure and expectations. Any necessary lab reports will be reviewed. Anesthesia standards require a pre operative physical from a family doctor.

We will provide you with full written post operative care instructions, your prescriptions, follow-up appointment dates, contact telephone numbers and instructions for care-givers at your pre operative appointment. No question will be unanswered.

 
Need more information?

Please contact us if you have questions. 

We are one of the leading cosmetic surgery practices in Canada.

 

You may benefit from liposuction if: