Liposculpture involves removing fat from the layer between the muscle fascia and the skin. The most commonly treated areas are abdomen, flanks, inner and outer thighs, arms, knees, anterior thighs, neck and back. When the fat cells are removed, it is extremely important that the surgeon creates a smooth contour in harmony with the patient’s physique. Creating this contour or figure for the patient requires the surgeon to remove fat to the right depth in both the area affected and all surrounding areas to avoid the pitfalls of knots and dimpling. This can necessitate the use of multiple Liposculpture techniques. In fact, Liposculpture has come a long way since it gained popularity as a procedure in the 80’s. Tumescent Analgesia, developed by Dr Klein, has improved results, comfort and patient safety. At Cosmedical Clinic we mainly use very fine 2-3 mm cannula which helps to obtain a smooth result and limits the scar size to 3 mm. The latest advancement in body contouring is Vaser Technology, which uses state of the art ultrasound to differentiate targeted fat from other tissues. Vaser Ultrasound ‘melts’ the fat before removal with Liposuction, which allows for a smoother result with less pain and downtime. In Liposculpture, the expertise of the surgeon is paramount. No matter what machine or method you use, obtaining a smooth, shapely result takes years of experience.
ABDOMINOPLASTY (TUMMY TUCK)
A protruding abdomen is a result of weak abdominal muscles, weight gain or pregnancy. It is a condition that causes distress to thousands of people. This condition does not respond well to diet or exercise because the skin and underlying muscles have been stretched. Today, a remarkable procedure called Abdominoplasty has been designed to flatten a protruding abdomen through the tightening of abdominal wall muscles and removal of excess fatty tissue and skin. Abdominoplasty is not a substitute for weight loss. The objective of the surgery is to improve the contour of the body by flattening and narrowing the abdomen. The best candidate for the surgery is the individual who is of normal weight but who has weak abdominal muscles and excess skin and fat. Age, obesity and smoking habits are some of the factors the physician considers when evaluating a candidate for his procedure. Abdominoplasty is usually performed in a hospital setting under general anaesthesia with the patient asleep. Pre-medication may be administered to relax the patient. The amount of improvement is individual and depends upon the extent of surgery and the patient’s skin tone, body, build and healing process. The post-operative hospital stay will be four days and a post-operative compression bandage for six weeks. Excessive activity will be restricted for at least one month after surgery.
This procedure is considered less invasive than a radical abdominoplasty due to the fact that there is no muscle suturing involved. The most ideal candidate for this procedure is the patient who has had regular long-term weight gain and loss and has generalised stretching of the abdominal skin with some fatty tissue often present. The scar may be the width of the lower abdominal section of the body, or may only be a short scar in the centre, depending on the amount of tissue to be excised. The post-operative recovery is generally a lot faster and normal activities can be commenced sooner. The procedure can be performed under general anaesthetic or local anaesthetic with sedation.
THIGH REDUCTION OR LIPECTOMY
As with the upper arms on those patients who may have experienced excessive weight-loss the upper thigh is a problem area where excess skin and fat cannot be hidden by clothing. Liposuction will not solve the patients dilemma and generally the motivation will be high enough to accept the scarring involved with this type of surgery. The scar will generally begin in the groin and traverse the inner thigh, running under the crease of the buttock and ending on the thigh. Occasionally the scar will need to extend down the inner thigh to above the knee if the amount of excess skin requires this. Post-operative scars are more visible on the body than the face. Incisions can be hidden by clothing in many circumstances but occasionally the scars will be visible when wearing shorts or bathing costumes. This procedure generally requires hospitalisation and the post-operative recovery is a little slower and more uncomfortable than other cosmetic procedures, but the benefits for the patient both psychologically and physically far outweigh the downside.
Before and after
BRACHIOPLASTY (UPPER ARM REDUCTION)
This is not a commonly performed procedure due to the possibility of obvious post-surgical scarring. However, even though patients are aware of this fact it is frequently requested due to the fact that the upper arms are an area difficult to hide during the warmer months, and when fashion dictates. The scar depends on the amount of redundant skin necessary to remove. A scar directly under the armpit from medial to lateral is the ideal surgical outcome, but this may not give a satisfactory outcome to the patient as only a certain amount of skin can be removed. A perpendicular scar to the previous scar extending to the elbow may be necessary for a more adequate skin and tissue reduction, giving the patient a more pleasing result. The extent of the scarring in this situation may not be as acceptable. Post-operatively, this can be a relatively uncomfortable procedure, but the outcome, depending on the patients desire for a satisfactory result, can be an extremely suitable course of action.