Liposuction Suction lipectomy is a technique which originated in France. The operative procedure removes fat which otherwise would not be absorbed by exercise or diet. Fat suctioning has been used in small areas such as the forehead, under the chin and neck, as well as abdominal areas, thighs, buttocks, lower extremeities and ankle areas. It can even be applied to the low back area where fat accumulates but cannot be easily shed. (It has also been used to remove fat from other sites of the body and transfer it to areas which are in need of contouring). Usually incisions for the suction catheters are made in inconspicuous areas and vary from place to place. The main problems inherent with this technique include bleeding, some scarring at the incision site, and possible infection. All of these side effects occur in very small percentages and are usually handled readily. Bleeding will necessitate evacuation of accumulated blood and the infection treated with appropriate antibiotics. Scars can be either injected with cortisone or revised by excising them. One must have significant skin turgor or elasticity in the skin to re-contour those areas which are now void of fat but which have been stretched. This concept is essential with respect to the thighs, abdomen and legs. This also can be applied to the neck and chin areas. Without elasticity in the skin, there may be a tendency for the skin to droop or fold. Also notable is that the suction catheter is a longitudinal tube-like device which may in the process of removing the fat, leave a rippling effect in the areas that are treated. However, this is usually not that conspicuous if at all noticeable. Similarly, there may be some tendency for darkening of skin in the areas involved from the breakdown of blood cells where fat has been removed. This is more notably seen in patients with darker complexions. There is also the interruption of nerves in the areas involved. This may cause a decrease in sensation or weakness in the involved muscle. Inquiries to facial motor nerves are rare but when they occur are usually transitory. It may take weeks or perhaps months to resolve. Again, this is extremely rare. The head and neck areas are usually suctioned at the time of a facelift, but may be done in selected cases without an adjuctive facelift procedure. A pressure dressing is oftentimes mandated, or even in rare instances, suction drains are left behind. Suction is usually performed under local anesthesia with heavy sedation. Occassionally, the procedure is done under general anesthesia for the facial and neck areas. For the lower extremities and abdomen, the suction procedure is done under local anesthesia with heavy sedation in only htose cases of limited suction. General anesthesia is usually mandated for thses more extensive suction procedures. Costs and charges for surgicenter use and general anesthesia vary and will have to be discussed pending the variety of suction sites chosen. Usually, patients do not require placement of suction drains for the abdomen, thishgs, buttocks or lower extremities. Instead a pressure garment is applied either as a girdle or a full length girdle or support stocking. For the initial several days after the operative procedure, the support garment will have the perineal and groin area cut freed to allow patients to use bathroom facilities, but keep the support garmet on at all times. After several days, patients are allowed to remove the garment for showering and bathroom use. Suctioning of the abdominal area and lower extremities necessitates wearing a support garment anywhere from two to six weeks depending upon the extent of suction and the propensity of the patient to accumulate fluid. there will be black and blue, of course, in these areas which may take several weeks to resolve. Most patients, however, are able to resume their normal level of activity within a matter of a week or less. To prevent a compromised blood supply to the skin and possible loss of skin, patients are not to smoke or chew Nicoret gum two weeks prior to and one week after surgery. For extensive liposuction, patients are encouraged to be placed on iron supplemental therapy and to donate their blood. This blood can be stored fresh for up to thirty days or even frozen up to five years. If extensive amounts of fat are going to be suctioned, this maneuver is mandated. If a patient is unable to donate their own blood, then the blood can be donated by a designated blood donor or close family member. In addition, patients are not to take Vitamin E or aspirin products at least ten days prior to suctioning. These medications affect clotting and can lend to bleeding. As is customary for such procedures, the surgical fees are expected seven to ten working days prior to surgery and the charges vary with the areas to be aspirated or liposuctioned. Please feel free to ask questions on any of the points in this letter of Dr. Kennedy or any member of his staff.
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