LIPOSCULPTURE

One of the more demanded operations is the liposuction of the inferior member and specifically of hips , internal aspect of the thighs and knees.

WE can say that liposuction is the technique and the liposculpture is the objective. What we try is to eliminate the excess of volume from given areas, looking for better definition of the ´body contour (liposculpture). The cannulae are designed to aspirate the fat by means of vacuum. The skin is undermined completely at superficial level to enhance its later retraction. Ultrasound assisted liposuction is a step further and consists of a high frequency vibrating cannula that vaporizes the fat cell and it aspires at the same time.

First that we do is to mark the zones to treat, drawing up curved lines very similar to the used ones in the geographic maps, so that we know where there are to aspirate more and where less. When draining these zones we try to readapt the skin to the underlying bone and muscle. When doing a liposculpture the objectives are:

- To redefine the lateral line of the hips from the abdomen, by means of the aspiration of lumbar zone, flanks and hip.

- To redefine the buttocks fold so that it is more curved and try to reduce its ptosis (sagging).

- To treat the inner thigh and knee, to create a more natural line and to eliminate the contact between both thighs in the internal part.

- In some cases we also treat the lower leg and ankle, to eliminate the straight aspect of the legs and to redefine the natural curved lines

Depending on the number of areas to be treated, we can use local anaesthesia; local anaesthesia with sedation; epidural or general. It does not imply a very painful post-operative period, since it is easily treated with common analgesics.

If the extirpated volume is not large, the patient can return to work life in few days.

After the liposuction, I prescribe a treatment that combines pressotherapy ( with a bandage that must be worn 24 hrs a day), massages and lymphatic drainage, exercises and, in some cases, diet. All these procedures are aimed at helping the cutaneous retraction to be more homogeneous and also at losing a bit more of fat volume. The habitual result is that the patient has lost one or two sizes in one month after the operation.

Does the removed fat occur again? No. The removed cells are not regenerated and the scar on the treated area keeps any deformity from ocurring. However, cells are like warehouses and they are able to increase their size, therefore, if a person puts on weight after the liposuction, the operated areas will fatten up too although not as much as if they had not been treated.

The popular statement that ' the fat moves and other areas then gain weight' is completely false. The thing is that after the operation, the number of cells in those areas is lower so they cannot gain the same amount of weight as other zones.

In those cases of large cutaneous flabbiness, liposuction is not a suitable procedure since the skin is not properly retracted and folds and irregularities appear. Lipectomy is indicated for all those situations, however scars are large. If this is not desired, we can try with liposuction but then the patient has to accept that some cutaneous irregularities may happen.

Ultrasonic liposuction facilitates fat extraction. I always use it in combination with conventional liposuction when performing liposculpture.