Liposuction, first introduced in the US in the 1980′s, has undergone dramatic changes in the last few years. Thanks to improvements in technique, equipment, and medications, most liposuction procedures may now safely be carried out in the office, without general anesthesia, and with only a few days’ recovery time.
Areas that benefit most from liposuction are those fatty deposits that don’t respond well to diet and excercise – chin, cheeks, jowls, neck, love handles, belly, inner thighs, outer thighs, and back rolls, to name a few. Liposuction is not a solution for obesity, however; as a matter of fact, liposuction results are generally most impressive when treating “problem areas” in patients of generally normal body weight.
While liposuction makes visible changes in body shape and proportionality, it does not, in general, decrease scale weight.
As with most of our surgical procedures, Dr. Nayak performs most liposuction procedures in our in-office AAAHC-accredited operating suite under local anesthesia or mild sedation.
During your liposuction consultation, Dr. Nayak will ask you what areas concern you. Dr. Nayak will likely ask you to point out, very specifically, what you’d like to see changed. Identifying exactly what needs to be addressed is the cornerstone of good results!
Dr. Nayak will then review your medical history form, and may ask for some additional information from you. Current and past smoking habits, or the use of nicotine gum or patch products, are especially important to mention to Dr. Nayak during this part of the consultation as nicotine dramatically reduces the chances of proper healing. Dr. Nayak will also pay special attention to parts of your medical history that need to be considered carefully when undertaking lipocution, such as uncontrolled high blood pressure, or any medications or supplements you may take that thin the blood or that may interfere with the safety of the lidocaine used in the procedure. In general, all over-the-counter pain/fever reducers (except Tylenol) are off-limits for 2 weeks before and after surgery, as are ginkgo biloba, St. John’s Wort, or high doses of fish oil, flax seed oil, or vitamin E.
It is also important to disclose to Dr. Nayak other surgical procedures you have had done in the areas of interest – previous liposuction, laparopsopic surgery, or open abdominal surgery such as appendectomy, for instance. Patients with previously diagnosed or treated hernias should also disclose these conditions.
The Physical Examination
Dr. Nayak will then examine your problem areas to determine exactly what must be corrected to achieve optimum results, and to ascertain whether or not you are a likely to achieve satisfactory improvement with liposuction alone.
The Preoperative Visit
Once you have decided to undergo liposuction, Dr. Nayak’s staff will help you schedule your surgical date, and, about 2 weeks preceding that, a preoperative visit. Expect to spend about 90 minutes in the office on the day of your preoperative visit. During this visit, you will be educated on before instructions, after instructions, and prescriptions. Written copies of all of these will be given to you at this visit, as well, and you will be able to fill your prescriptions ahead of time. You will also be reminded at this time to avoid for 2 weeks before and after surgery any medications and supplements that thin the blood.
Also at the preoperative visit, the surgical consent form will be read to you, and you will have an opportunity to discuss with Dr. Nayak any questions you still have remaining. Finally, at the conclusion of this visit, the balance of your surgical, facility, and anesthesia fees will be due.
The Surgical Visit
In general, you will be asked to arrive at 7:15 AM the morning of your planned surgery. If you are having your surgery at an outside facility, you may be asked to arrive earlier. You should have nothing to eat or drink (not even water, candy, or gum) after midnight the night before your procedure. If Dr. Nayak prescribed antibiotics, oral sedatives, or if you take blood pressure medication in the mornings, you may take these with a small sip of clear water.
You will need an adult driver on the day of your surgery to bring you and to take you home. Your companion may wait in our comfortable reception area, watching TV, reading, and enjoying coffee, soda, and snacks. Alternatively, if your companion wishes to leave a cellular telephone number, we can call him or her with updates and also at the conclusion of the procedure.
Upon your arrival, Dr. Nayak’s staff will greet you and review your medical history, looking for any new changes since your initial consultation. Dr. Nayak and his staff will also confirm that they and you are in agreement about which procedures are to be performed, and those areas will be marked with you standing upright. Photographs of the markins will also be taken. If you are a woman under 50 and have not been surgically sterilized, a urine pregnancy test may be performed. In any case, you will have one last opportunity to have last-minute questions answered and use the restroom, and will be escorted to our AAAHC-accredited surgical suite.
Once there, you will be positioned comfortably, and painless blood pressure and oxygen monitors will be placed on your arm and finger. You may also bring your own iPod or CD’s, or listen to our choice of soothing music.
Dr. Nayak and his staff will then perform one final “time-out” aloud to ensure they are about to embark on the appropriate procedure on the appropriate patient. The areas to be sculpted will then slowly and gently be numbed with local anesthesia, a process that is usually totally painless. By this time, most patients feel very relaxed. Once numb, the majority of patients actually fall asleep intermittently while the procedure is being performed. Those who do not remain relaxed but awake, and Dr. Nayak and his staff get the welcome opportunity to talk with you during the procedure.
The liposuction itself will take place with tiny (1/16″ to 1/4″ wide) instruments called microcannulae, which are placed through multiple round adits (holes) made in and around the area to be suctioned. These holes are generally smaller than 1/16 inch in size, and generally heal nearly imperceptibly over time. There will be no actual incisions, no drains, and no sutures.
Your Recovery – Day 1
At the conclusion of your procedure, Dr. Nayak will tell your companion how everything went, and he or she will have the opportunity to see you. You will be dressed in absorptive pads and gentle compression garments at this point, and will likely be relaxed, comfortable, and in little to no pain.
You will be asked to spend 1 hour with us prior to being discharged. Dr. Nayak will call you the evening of the procedure to check on your progress, and you will also be given Dr. Nayak’s personal cellular phone number in case questions should arise after hours or on the weekends.
Your Recovery – Week 1
Most patients feel no pain whatsoever immediately after surgery. Many patients find they nap intermittently the first afternoon. Later in the evening, most patients report a feeling of soreness, like a hard workout, in the treated areas. Pain is usually absent or mild, with tylenol usually being sufficient for the mild soreness.
Most patients need to wear and change the absorbptive pads for 24-48 hours after the procedure, as the local anesthetic solution will leak back out of the tiny adits. This process is normal, and minimizes bruising and swelling.
Most patients will be asked to return to the office for a quick checkup the day after surgery. You will be examined, and your aftercare instructions reviewed. You may then return home and shower at that point. The vast majority of patients are comfortable to return comfortably to work at 2-4 days.
On the 6th or 7th day after surgery, you will return to the office for a checkup. Many patients can already appreciate in improvement in silhouette at this point, although some swelling from the procedure remains and masks their final shape at this point.
Your Recovery – Long Term
Over the ensuing weeks and months, you will find the adits through which the fat was removed will fade from pink to light, and nearly vanish. By two weeks after the procedure, you will no longer need to wear the supportive or compressive garments Over the next 3-4 months, the tiny bits of remaining swelling will resolve, and your final result will emerge.