Obesity is 20% more weight to your ideal body weight. Fat accumulates when calories intake exceeds expenditure. Following pregnancy, fat accumulation takes place abdominal wall stretch causing striae. Fat accumulation result in undesirable abdominal shape & change in quality of skin causing cellulite and dimpling. Liposuction is surgical aspiration [removal] of subcutaneous fat [fat under the skin] by use of cannula attached to a vacuum pump. Liposuction has become an extremely popular procedure in today’s body – conscious society. Liposuction is not substitute for healthy lifestyle. It is not offered as a treatment for obesity.It is to remove genetically distributed or diet resistant fat. Diet, exercise & life style programmed are very important as advised by consultant & dietician. Surgery should not be the first step in enhancing body contouring because it is likely to lead to failure or only temporary improvement. Liposuction can be done in thighs, buttocks, calf, arm, face, neck etc also.
Person should understand that if major weight gained after surgery the contour result could change from the expected post-operative appearance. Good skin tone and dermal quality are required for shrinkage after liposuction. In case of loose sagging skin with folds, Dermolipectomy – Abdominoplasty is required. Aesthetic goal of an abdominoplasty are to improve contour of abdominal wall, to minimize scarring, avoiding[excising] saggy extra skin & to maintain naturally appearing umbilicus. It also helps to strengthen abdominal wall muscles & prevent or correct hernias. Normal Abdominal shape has different fat distribution & abdominal shape in male & female. In female – Hourglass shape, narrow at waist & wider at hip, Ideally the female waist to hip ratio is 0.72. Small fullness above pubis is scaphoid [boat shape] above it. Umbilicus in center between xiphoid & pubis at ant superior iliac crest with slight depression around. Fat tends to accumulate in lower trunks, hips, thighs & buttocks give pear shape. Male Abdominal Shape is becoming narrower with descent from chest to hip in V shape Fat accumulation tends to occur Circumstantially around the abdomen & flanks. It increases abdominal girth. [Apple shape]. Well shaped abdomen is attractive because it reflects good health & sexual fitness with increased waist circumference, there is increased risk of diabetes, hypertension & cardiac risk. Woman with larger breast & narrower waist have shown higher level of hormone of conception. Smaller waist to hip ratio is more attractive & healthy. Abdominal shape deformity is result of sequel of significant weight fluctuation and after bariatric surgery in the form of excessive skin with umbilical ptosis.
liposuction is done in skin with good elasticity without sagging of umbilicus & folds. Small quantity liposuction for localized area, Cellulite & bumps can be done under Local Anesthesia where risk involved is almost nil. Large volume liposuction is done under general anesthesia have risk similar to any surgical procedure. Time limit kept is 4 to 6 hrs for one surgery. Additional fat removed after 3 months. Larger the volume aspirated, more is the risk. Fat removed more than 5 liters is considered large volume liposuction. This is not weight reducing in stead, body contouring surgery, despite corresponding weight loss takes place. Return to work depends upon many factors, the person’s profession, person's general health, physical & emotional recovery & desire to return to work. After an average volume liposuction [2-4 liters], patient can return to physically non demanding work with in 24 hours. small volume [less than 2 liters] can return to work on same day.some amount of liquid fat may drain from slit made for procedure in pad put under pressure garment.
One should plan recovery time for some rest for lot of early swelling in mega-liposuction otherwise recovery time is prolonged. Patient will experience red –yellow tinged, discharge from incision site for 24 to 36 hrs. Maximum swelling can be expected on day 3 & 5. one must were required pressure garment to give uniformity and to prevent accumulation of undrained liquid fat. It helps prevent future recollection of fat. If the one has bruising, will spontaneously resolve in 7 to 10 days. Patient should massage liposuctioned area after 2 weeks for resolution of oedema. 80% oedema resolve with in 4 to 6 weeks & takes full 3to 4 months. Patient can start ambulate on same day, After major liposuction, pt may feel fatigue for few days. Despite best efforts surface contour abnormality, asymmetry & under resection are some time observed post operatively which may require secondary procedures. Person under going procedure should get realistic idea about expected outcome as well as time frame for resolution of problems.
Abdominolplasty is done when there is fat accumulation with reduced skin elasticity, sagging of umbilicus & lower abdominal skin. Body lift surgery is also done in severe cases & post bariatric surgery skin laxity. Here excess skin and fat is removed along with umbillical reposition in youthful manner.Lower abdominal weak muscles are also strengthened.over the experience of years we have found that there is no new collection of fat here.In post-barriatric surgery weight loss, tummy tuck and body lift etc.prevents recurrence of obesity and weight gain.
Operation is individualized for each person differently. This surgery is repeatable at 4 to 6 months interval. Risk involved with any major surgery's here also. Other risk can be infection seroma, dehiscence, skin loss,hypertrophic scar. There is limitation to surgery because of bone structure, intra – abdominal fat and existing scar. Surgery is not advisable in following conditions
Effect of this surgery last very long even life long if major weight fluctuation are avoided Fat removed by liposuction can be used to enhance appearance on face & fill up other depressions & fold in body as filler material.