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Liposculpture: plastic surgery redistributes localized fat and shapes the body
Plastic surgery - photo: Getty Images
Klein's solution - consisting of saline solution and adrenaline - is first infiltrated to reduce the chances of bleeding and, consequently, surgical trauma. The liposuction cannulas are introduced through the skin and into the adipose tissue (layer that comes just after the skin), from where they aspirate - through a vacuum system - the localized fat. The points at which the cannulae are inserted vary according to the patient's anatomy and the technique used by the surgeon.
Liposuction can be done under general, epidural or local anesthesia, depending on the number of regions covered. If the anesthesia is general, there is a need for orotracheal intubation and the use of breathing apparatus. In general, liposuction scars are about a half-centimeter, but they can become almost imperceptible over time, and do not cause any discomfort.
"The fat is then treated - the removal of ruptured fat cells from blood and anesthetic - and the fat is grafted in a new place, "explains plastic surgeon Eduardo Andrade Filho, of Espaço Cariz, in Campinas, São Paulo. "The graft is placed through thin syringes at the desired location, giving new volume and shape to the site." The surgical procedure lasts, in average, two hours.
Physicians who can perform this surgery
Plastic surgeon André Eyler, member of the Brazilian Society of Plastic Surgery, explains that legally all doctors can perform liposculpture. However, it is indicated that the patient should seek a professional plastic surgeon who can perform the technique. who has adequate training and preparation, that is, specialty in plastic surgery.
Parts of the body that can undergo liposculpture
Liposuction can be performed in any region where there is localized fat. "At first, fat can be grafted anywhere, the areas of greater demand for fat are glutes, face, hands and breasts," explains André Eyler. The specialist explains that it is possible to graft the liposuction fat into different regions of the body in only one procedure, however care must be taken not to increase surgery time excessively.
If the patient decides to treat different areas in different surgeries, a minimum interval of one month between surgeries. If you want to treat the same area, a minimum interval of six months is required until the swelling of the region disappears.
Better results of liposculpture
According to André Eyler, face lipoenxertia has more impact results, followed by rejuvenation of the hands and gluteal augmentation.
According to plastic surgeon Eduardo, the best results happen when the localized fat is under a region of skin of good elasticity and without excess. Locations of localized fat but with increased sagging of the skin should be accompanied by removal of local skin.
Amount of fat removed
André Eyler explains that the amount of fat removed depends on the biotype of each patient, is very variable. The maximum amount removed is up to 7% of body weight in the wet surgeon (performed with infusion of solution that reduces bleeding and anesthesia in the region) and 5% in dry surgery (without infusion of the solution), according to the norms of the Council Federal of Medicine.
Liposculpture Indications
Liposuction - Photo: Getty Images
Liposculpture is indicated for patients with localized fat accumulation and areas that need filling due to lack of fat tissue. "It is preferable that these people are within normal weight, generating more satisfactory results", explains André Eyler.
Contraindication to liposculpture
Previous pathologies, such as heart diseases, pulmonary alterations, diabetes, arterial hypertension, anemias, among others , uncontrolled, make the procedure risky. In the specific case of uncontrolled diabetes, it can affect the healing process. "This pathology can lead to partial or total obstruction of the vessels, which impairs tissue oxygenation and, consequently, the formation of collagen and elastic fibers," explains plastic surgeon Márcio Castan, a member of the Brazilian Society of Plastic Surgery. However, it is known that most diabetic patients are carriers of arterial diseases, and are more likely to develop tissue necrosis. "This procedure should be performed in patients with localized fat accumulation and not seen as a treatment for weight loss, since liposuction should not take more than 7% of body weight, that is, if the patient weighs 60kg, we should not liposuction more than 4200ml, "explains Márcio Castan. In general, who should not be submitted to liposculpture are patients who are thinking of this procedure as a weight loss measure. Psychological changes, such as depression or some body dimorphism, such as anorexia, also contraindicate liposculpture.
Pre-surgery care
Every surgery should be preceded by a few details. These details consist mainly of a correct indication for the surgery to be performed, clarification to the patient or his / her legal guardian about the possibilities of results and the existing risks of a surgical / anesthetic procedure and a preoperative with exams pertinent for each case.
Even before the surgery the patient should, if possible, follow some measures such as suspending some medications that may harm the operative act, such as tablets containing acetylsalicylic acid - which change blood coagulation -, among others, always remembering that any medication being used should be of the surgeon's science. The contraceptive pill should be discontinued, if possible, one month in advance, as studies point to its thromboembolic potential.
Smoking should be discontinued 30 to 60 days in advance, as it has direct interference in healing. Regarding food, there are some foods that should be avoided by interfering with bleeding, such as garlic and chestnut from India.
It is critical that the patient informs the doctor about any type of infection in the days preceding the procedure, since the the major source of surgical infection is the patient itself.
Pre-liposculpture examinations
In general, laboratory tests are requested, such as a complete blood count. The presence of anemia, infections, changes in platelet counts will be evaluated. It is considered prudent to request sodium, potassium, urea and creatinine dosages in order to assess renal function. A complete coagulation test is also required to check for blood clotting disorders.
After a certain age, it is advisable to order fasting blood glucose to assess whether the patient has diabetes. In some cases it may be necessary to have a urine urinary examination with a urine culture, which can diagnose a urinary tract infection.
For older patients, other tests become necessary, such as the electrocardiogram and chest X-ray to assess cardiac and pulmonary function. It is an option to request beta-HCG for women of childbearing age to rule out pregnancy.
There are also some tests that are specific to each surgery. In the case of liposculpture, total abdominal and abdominal wall ultrasound can detect hernias and intra-abdominal pathology that may cause confusion in the eventual operative diagnosis. "For example, if the plastic surgeon performs a liposuction of the abdomen and does not know that the patient has gallstones, abdominal cramps in the postoperative period may induce them to believe in some breach of the cavity through liposuction," explains Márcio Castan. "It is still prudent to request specific tests according to the patient's pre-existing pathologies, in order to know if the condition is under control and whether or not the patient can undergo the surgical procedure."
Hospital stay
In general, liposculpture does not require hospitalization, that is, the patient can go home after a period of time through a post-anesthetic recovery room, remaining in the hospital between 12 and 24 hours. Even so, such surgery must be performed in a hospital environment, always making sure the total security of the establishment.
Postoperative of liposculpture
Until the desired result can be achieved, several phases are faced by the patient. Thus, edema (swelling), "staining" of blood accumulation in the subcutaneous tissue, hypersensitivity of some areas, insensitivity of others, are common to all patients. Some patients will present these phenomena to a greater or lesser extent than others and usually resolve in approximately 21 days. A short period of dissatisfaction may occur in the first few days, due to the transient aspect, usually arising from the anxiety to achieve the final result as soon as possible.
Modeling belt
The use of postoperative strap, or modeler, is indicated by some doctors and not by others. The modeler may play an important role in the final result of liposculpture, but it is not a guarantee of satisfaction of the result. It will help "compress and reposition" the tissue with the liposuction to the place where it should remain. The use of the postoperative tape is constant, being withdrawn only for a shower, during the first 30-45 days.
Postoperative medication
As with any postoperative, the greatest concern is with pain and possible infections. Then in this period the use of analgesics is indicated, depending on the degree of pain presented by the patient, and antibiotic as prevention of infections. It is still prudent to assess the individual risks of thromboembolism. For patients at increased risk, postoperative anticoagulant medications may be used.
Physical exercises
Progressive walking, according to the disposition, is totally liberated, but physical activity in general must be avoided for a period of 21 to 30 days, varying from how the patient will respond to surgery and the amount of fat removed.
Risks related to liposculpture
As with any surgical procedure, liposculpture is also subject to eventual complications. "These complications can range from milder complications such as prolonged swelling, seroma (which is the accumulation of fluid in the space that has been created by liposuction), infections to more severe complications ranging from skin necrosis or grafted fat, which can lead to an abscess, to perforations of viscera and pulmonary embolism, "explains plastic surgeon Márcio Castan.
The specific complications of liposculpture are usually related to the unsatisfactory result that can be obtained, such as:
- Irregularities (
- Base problem, such as depressions or deformities, unresolved;
- Hypercorrection of the underlying problem (if the butt is larger than expected, for example)
It is known that liposculpture went awry when, after the period of adaptation of the organism to surgical trauma, the idealized and projected result was not obtained.
Post-surgical treatments
Lymphatic drainage helps to reduce swelling, avoids accumulation of fluid in the space created by liposuction (seroma), activates blood circulation and relieves pain. Also, through manual lymphatic drainage or with devices, it is possible to assist in the removal of bruising, accelerate the healing process and postoperative recovery, as well as minimize ripples, irregularities and prevent the appearance of fibroses that may arise in the post- "The lymphatic drainage should be done in a way that stimulates the general lymphatic circulation: in the operated area, it should be more detailed and directed, in a slow and delicate way with the purpose of reducing the inflammatory process caused by the surgery," explains the plastic surgeon Márcio Castan
Check before the consultation
The doctor that you will consult must be registered with the Federal Council of Medicine (CFM), it is possible to do this check in the site of the institution
- The professional must be a member of the Brazilian Society of Plastic Surgery. Other institutions do not evaluate the training and experience of the professional of this area
- The surgery must be done in a hospital that has credit for performing medium-sized surgeries. Contact the hospital to check
- Talk to someone who has already had surgery with the same doctor and find out about the procedure and results
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