Liposuction, Liposculpture, Fat Removal

Liposuction for body and neck sculpting and contouring is the second most common operation performed by board certified plastic surgeons. Liposuction or suction lipectomy is the gentle and careful removal of fat from undesirable areas of the body on women and men such as the abdomen, thighs, breast, neck, back, arms, or lower legs. Liposuction offers the opportunity to change the contour of your body while minimizing scar. Most other operations and forms of fat removal require trading a scar for a change in appearance. With liposuction, small cannulas can be safely used through very small incisions made in natural creases or folds to carefully and gently remove excess body fat and sculpt areas of stubborn fat to transform your body with a natural appearance. Patients recover quickly and return home the same day as the procedure. Small areas can often be removed with local anesthesia alone, while larger areas may require some sedation or anesthesia. Patients return home the same day with limited discomfort. Dr. Taylor and Dr. Sullivan are selective about choosing patients for an operation. If you have undesirable areas of fat or hope for contouring such as a “6 pack” abdomen, consider meeting with Dr. Taylor and Dr. Sullivan, Boston plastic surgeons and cosmetic surgeons, to determine if you would be a good candidate for liposuction.

Why get Liposuction?

An attractive and fit abdomen is the goal of most people. Despite diet, exercise, a Boot Camp class, or rides on your new Peloton, an improved abdominal contour is not always possible. Liposuction is the ideal treatment for patients who, despite diet and exercise, discover than an improved or sculpted contour is not possible. Liposuction is a relatively minimally invasive operation that improves contour and profile by removing excess fat from stubborn areas such as the abdomen, buttock, thighs, ankles, arms, flanks, neck, and "love handles". Through natural creases or folds, Dr. Taylor and Dr. Sullivan insert a microcannula and precisely remove fat or sculpt areas of fat. Once removed by liposuction, fat does not return to that area, which is why liposuction is superior to the non-surgical methods promoted by some clinics, such as cooling, heating, radio frequency ablating, or laser. If you have had one of these nonsurgical treatments and are disappointed with the results of expensive and ineffective treatments, consider scheduling an appointment with Dr. Taylor and Dr. Sullivan to learn more about liposuction.

What is Fat Trasnfer or Fat Grafting?

When liposuction is performed, many patients wish to transfer some of the fat to other parts of the body, known as fat transfer or fat grafting. Fat grafting can be used to restore or even create volume in other areas of the body, breasts (breast augmentation with fat transfer), face (facial fat transfer), hands (hand rejuvenation), contour deformities or scars.

LIPOSUCTION AFTERCARE INSTRUCTIONS

• In the week before your operation:

o Consider eating pineapple, it may help reduce bruising

o Consider supplementing with Arnica montana, it may help reduce bruising

o Complete household chores and prepare meals for the first few days of postoperative recovery

o Follow preoperative instructions with eating, drinking, and medications

o Order two compression garments specific to your size and planned areas of liposuction. The garments do not need to be expensive. Dr. Taylor and Dr. Sullivan can make some recommendations of garments that can be ordered from Amazon or online.

• Postoperatively, get out of bed and walk (with assistance) every few hours after your operation to decrease the chance of postoperative problems such as blood clots.

• Practice 15-20 deep breaths every hour to keep your lungs open.

• After surgery, it is important for you to have someone available to stay with you for the first 24-48 hours, as you may feel drowsy. You may require help the first few times you get out of bed.

• Please take your medications as directed by Dr. Taylor or Dr. Sullivan to manage discomfort or symptoms.

o Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours

o Ibuprofen (Motrin) 800 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours

o Gabapentin 300 mg every 8 hours for 7 days

o Vitamin C 500 mg daily for 50 days

o Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though many patients may not need it

o Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day

o Zofran 8 mg every 8 hours if needed for nausea

o Scopolamine patch will be placed behind the ear on the day of surgery and can stay for 3 days

• Eat a light diet for 2-3 days and avoid spicy food. Some suggestions to ease abdominal discomfort or indigestion after surgery:

o Drink water or warm liquids

o Prune juice to prevent constipation

• You may shower or sponge bath the day after the operation with assistance and wash your skin as you normally would with soap and water. Avoid soaking the incision, although It will not hurt to get a splash of water on the wounds. Gently pat dry after washing.

• Wear the compression garment continuously for 3 weeks after surgery, then for 12 hours of each day for an additional 3 weeks, and thereafter as needed for comfort. You can take it off to shower. The first time you remove the garment, please have someone help you. If you feel dizzy or light headed, sit down or lie down. The garment helps control swelling and fluid build-up.

• Most wounds will be closed with absorbable sutures that are buried and skin glue. The skin glue forms a barrier to water. Please do not remove the glue, it will fall off on its own after a few weeks. Do not apply any lotions, potions, ointments, creams or solutions (e.g. no hydrogen peroxide or alcohol) as they can be harmful to the fragile healing tissue.

• Do not smoke or expose yourself to smokers or nicotine as skin and wounds can be compromised.

• Infection is uncommon, though please call Dr. Taylor or Dr. Sullivan immediately at any sign of infection which would be signaled by fever, increased pain, new redness or swelling.

ACTIVITY

• For the first few days following surgery, raising your blood pressure and heart rate can cause bleeding. Stress on your muscles near areas of liposuction or vigorous exercise could cause bleeding and swelling. We recommend walking 15 minutes 2 to 3 times per day and gradually increasing activity tailored to your recovery.

• Please do not drive until turning the steering wheel can be done safely and without pain (usually 5 to 7 days). Do not drive while taking pain medications such as oxycodone.

• Massage to the areas of liposuction can help increase circulation and soften firm areas under the skin. Please wait at least 3 to 4 weeks after surgery to start massage to avoid increased swelling.

GENERAL OUTCOMES

• Moderate swelling and bruising is to be expected. Bruising may last for a few weeks and will move down your body due to gravity.

• You may find that your clothes are tight and may not fit as easily for at least 6 weeks after the operation. A feeling of tightness is also to be expected. Please be patient, the swelling and feeling of tightness will gradually subside over the following months.

• You may notice that you actually gain weight following liposuction. This is because the body retains fluid with swelling in response to the surgery. The swelling may persist for 6 weeks or more before it slowly decreases. A change in body contour and the way clothes fit is the goal of the operation, rather than a change or decrease in weight.

• Tingling, itching, and numbness of the skin are all normal after liposuction. Tingling and itching are signs of healing and will resolve. Sensation usually returns gradually and slowly over weeks to months. Please be patient and avoid resting against hot surfaces, which can injure or burn the skin.

• Scars take one full year to mature. Although small, you may notice that liposuction port sites become red, raised and firm for several weeks to months before becoming soft, flat and pale. Avoid Vitamin E as it can irritate the scar. Mederma has no proven benefit and is not worth the expense. Silicone cream or skin moisturizer with sunscreen and gentle massage may be helpful.

• A small amount bleeding from the incision is expected. Please call our office (617-492-0620) if you have:

o Continuous bleeding

o Significantly more swelling on one side when compared to the other

o Worsening pain

o Fever, spreading redness or irritation of the skin

o Shortness of breath

It is important to be seen by Dr. Taylor or Dr. Sullivan after your operation. They will see you in follow-up appointments at 1 week, 3 to 6 months, and 1 year or as often as needed post-op. Call Taylor and Sullivan Plastic Surgery to schedule your appointments at (617) 492-0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492-0620.

Download our Liposuction postoperative instructions here.