Body Remodeling

Liposuction and liposculpture

Liposuction is one of the most requested procedures in plastic surgery. The technique has been refined over the years and now allows for significant results. Unfortunately, the apparent ease of performing the procedure has led even "improvised" surgeons and non-specialized practitioners to engage in an operation that, to be done well, is anything but simple and requires experience and artistic sense. The skill of the surgeon lies in shaping the patient's body, molding it from the inside.

Which parts of the body can be suctioned?

With few exceptions, almost the entire body can undergo liposuction: neck, arms, chest, hips, thighs, buttocks, etc. Localized liposuction, i.e., of a single region (e.g., knees and saddlebags), is indicated if the excess fat accumulation is limited to one part of the body. In other words, aspirating and shaping one area may disrupt the harmony of the rest of the body. For this reason, it is often advisable to aspirate the adjacent areas to make the figure more harmonious.

Liposuction, Liposuction, Liposculpture: How many terms!

Unfortunately, there has been a lot of confusion about the terminology, often for reasons far from scientific discussion. The truth is that liposuction and liposuction indicate the same method. Some prefer the term liposculpture because it emphasizes the shaping and artistic act more.

True distinctions are only made for these terms:

Microliposuction It is liposuction that uses very fine cannulas; it is indicated only for very modest localized deposits; it also improves cellulite because the thin cannula can be immediately taken just below the skin where adipose accumulations are located.

Megaliposuction It is massive liposuction that removes significant amounts of adipose tissue (up to 30 liters); the technique is rigorous, requiring a particular preoperative preparation with the deposit of some blood bags just before the intervention. It is performed by infiltrating large amounts of fluids into adipose tissue, which is then aspirated practically bloodless. It is a technique not without risks, albeit limited by the high preparation of the few teams that perform it. It is indicated only in cases of very substantial but localized obesity. Patient selection is fundamental.

Ultrasonic liposuction

Uses a device capable of emulsifying fat, breaking the adipocyte wall, causing the release of contained fat. The technique involves massive infiltration, the passage of the ultrasonic cannula, and finally, aspiration with a medium-caliber liposuction cannula. The advantage of the technique lies in respecting blood vessels and nerves, obtaining blood-poor aspirate. On the other hand, it is a technique that requires about twice the normal operating time, and not in all body regions does it yield superior results to traditional liposuction. It has proven to be of great utility in relaxed areas because the passage of the cannula beneath the dermis causes contraction with a reduction in sagging. The risks of burns, once greatly feared, are now negligible thanks to modern machines on the market.

Superficial Liposuction

The procedure involves aspirating fat from the surface to the depth, thus stimulating the relaxed dermis to contract. It allows flattening a bulging abdomen and shaping the inner thigh without losing tissue tone.

Laser-assisted liposuction utilizes equipment with a laser fiber that, when introduced into adipose tissue, is supposed to melt it. The technique was introduced to the market under the name Smart Lipo.

It is very rare to find a Plastic Surgery Specialist who uses it, and that speaks volumes. Issues related to technique and equipment include:

  1. There are no published studies in reputable international journals on the effectiveness of the technique or on numerically relevant case studies.

  2. The procedure involves an initial phase of passing the probe through adipose tissue, followed by the aspiration of the content released by adipocytes with normal liposuction cannulas. Therefore, the operating time is doubled.

Type of anesthesia, duration of the procedure, and postoperative period

Depending on the type of procedure and the volume to be aspirated, liposuction can be performed under local assisted anesthesia, spinal anesthesia, or general anesthesia. It is important to note that even a modest aspiration is still a surgical intervention and, therefore, requires all necessary safety guarantees. The procedure can be done on a day-hospital basis, or an overnight stay can be requested. The process begins with the infiltration of tissues with a solution of anesthetic and vasoconstrictor to minimize bleeding. The next step involves the aspiration of adipose tissue using cannulas of various diameters. The smaller the diameter of the cannula, the less trauma and the lower the risk of depressions or irregularities. After the procedure, compression is applied with elastic stockings or a garment. Sometimes, the aspirated area is covered with a special sponge that provides additional compression.

The sensation after the procedure is akin to bruising. The best trick for a quick recovery is to move as much as possible, always doing a little more than what seems challenging. After removing the compressions, the legs may swell a bit, so it is necessary to wear draining stockings (35-70 denier) for several days. The swelling will gradually subside in the following months. It is advisable to rely on an experienced esthetician for postoperative lymphatic drainage and connective tissue massages.

Liposculpture: artistic expression in plastic surgery

Liposculpture is understood as a 360° form of body shaping that goes far beyond mere liposuction. It is a procedure that considers the body in three-dimensional form and aims to shape its volumes while fully respecting overall harmony. Sometimes, the body to be sculpted presents not only excess fat but also depressions, adipose mounds, and a lack of projection of anatomical parts. For example, even in the presence of excess lateral fat, the buttocks may appear saggy and poorly projected. What to do in this case? If one does not wish to resort to buttock implant surgery (an operation burdened by a high rate of complications), the condition can be improved by treating it with lipofilling: a portion of the adipose tissue taken from the lateral areas is appropriately aspirated, treated, filtered, and then injected into the buttocks to enhance projection.

Lipofilling, in the context of liposculpture, proves to be extremely useful in the outcomes of liposuction, where depressions caused by improper use of the cannula are evident.

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