Liposuction

Ultrasonic assisted liposuction
The proportions of the body do not always represent the individuals own expectations or ideals. The inborn numbers of fat cells remain constant through life and they are located where they have been placed by nature. Thus, more or less visible fat deposits can persist in areas where you do not want them to be in spite of weightreduction and this situation is the indication for liposuction or liposculpture. All areas of the body can be treated. The typical male abdomen with protruding musculature depends on fat accumulation in the omentum and can only not be treated by dietary fat reduction and not by liposuction.

Through the years using finer cannulas has refined the techniques in liposuction. Microsculpturing directly under the skin makes it possible to treat areas with rather loose skin. With the ultrasonic assisted liposuction the fat cells at the tip of the cannula bursts and the content is simultaneously aspirated. This technique has been used at the clinic since 93 and comparing scientific studies here and elsewhere have concluded, that there is no differences in outcome between liposuction and ultrasonic assisted liposuction nor is there any differences in safety. On the contrary, the ultrasonic procedure causes subcutaneous burns that can cause chronic pain in the treated areas.

The method is regarded as a contouring of the body, not as a method for weightreduction. The achieved contours will be permanent if the life style is altered. Otherwise other parts will thicken. The total fat mass is reduced and if the caloric intake stays the same and the physical burning of the energy stays the same, the same energy as before has to be stored in a smaller storage chamber.

Principle: By thinning of the fat layer a reduction of the volume is achieved locally. The elasticity of the skin makes it redrape over the new-formed "base". The skin retraction has of course its limitations and this procedure should be used with care in areas wit skinredundancy.

Technique: The area to be treated is marked and small, 3 6 mm, incisions are placed in inconspicuous areas. With long, thin cannulas connected to an ultrasonic generator the fatcells are disrupted in the whole area to be treated and the contents of the cells is simultaneously sucked out with low vacuum until the desired thickness of the fatlayer is achieved. Not all the fat is removed as not to cause irregularities dimples furrows and skinfolds. A compression garment is applied and this should be worn for 3 - 4 weeks. Due to swelling, the effect of the treatment will first be visible after approximately 4 weeks.
The procedure without ultrasonic assisted liposuction is identical and equivalent.

Anaesthetic: According to localisation or area to be treated either conscious sedation and local tumescent anaesthetic or general anaesthesia.

Operating time: 1 3 hours.

What happens afterwards?

	Surprisingly little postoperative pain. Changing of position causes some discomfort.
	Stitches are removed after 8 10 days.
	Largevolumeaspiration causes fatigue for some days.
	Normal activities should be taken up immediately.
	Physical activities should be postponed for 2 3 weeks.
	Massage can be beneficial.
	Numbness in the treated areas is common for 2 3 months.
	After ultrasonic assisted procedures are painful spots on palpation common. The scarformations under the skin will be felt as nodules, which will disappear gradually.
	Swelling and bruising far below the treated area are common.

This text is edited and controlled by Dr. Per Gunnar Opitz, Opitz plastikkirurgiska klinik i Malmö Sweden