Liposuction What to Expect

The Day Of Your Liposuction Procedure

Come early, you will be filling our paper work prior to the procedure, so it would help to be here 15-20 minutes early.

You will be taken back to the procedure room and asked to change into a gown. A formal consultation with the liposuction specialist will take place to assure that you are having the proper areas treated and that all your questions have been answered. Once the areas have been determined, we will take before pictures and mark the areas to be treated. Assuming you agree with the areas to be treated, you will then be given the medications required for the procedure. Our staff will then take your vital signs and measurements at this time to give us a baseline. If you are anxious we will give you xanax (anxiety medication) which will make you drowsy and relaxed.

The Liposuction Procedure

1. The first part is getting you numb. This part can be a little uncomfortable since you are not numb yet. Your skin will be cleaned and the 2mm adits (entry holes for our tiny instruments) will be strategically placed in areas that are less visible. You will feel a pinch and slight burning sensation from the local injection of lidocaine. Then a very small canula will be passed into your fat layer and a dilute solution consisting of saline, lidocaine and epinephrine (lidocaine is the numbing agent, and epinephrine constricts the blood vessels to minimize bleeding) will be sprayed into the fat layer. This will get the whole area numb and help decrease any potential bleeding. This process feels like a pinching sensation and is very “weird” but not terribly painful for most. Most people tolerate this part.
2. The next part is the debulking of the fat. A small 3-4mm canula will be passed into the now numb fat layer. The canula is attached to suction and will remove the fat. You should be pretty numb at this point and will only feel pressure and vibrations from the liposuction canula. Occasionally, there are areas that are not entirely numb, so if you feel any pain, the liposuction specialist will stop and put more numbing medication in that area. Most people feel very little discomfort during this process, but if you do have difficulty tolerating this, simply ask for more numbing fluid.
3. Once the bulk of the fat has been removed, a smaller canula will be used to “sculpt” the area and ensure everything is even and smooth. The specialist will also double check all the areas treated to assure the fat has been removed evenly throughout the areas treated.
4. You will then be cleaned up and garments will be applied to the treated areas. Depending on how much of the anxiety medication, Xanax that you take; you may feel drowsy and a little dizzy. If you choose not to take xanax, then you will feel great. In fact, since the numbing medication can potentially work for 18-24 hours, you will not have much discomfort until the next day in most cases. If needed you are welcome to rest in our recovery room as long as you require. Your vital signs will be taken before, during and after the procedure to ensure your body is tolerating the procedure well.

After The Liposuction Procedure

Immediately after the procedure, most people will still be numb and feeling very little pain for 18-24 hours. Since we inject a lot of fluid into your fat to get you numb, you will be draining this fluid afterwards. The more fluid that drains out of you the better. Any fluid that does not drain out will be reabsorbed by your body, and this tends to take longer and cause more swelling. So it is in your best interest to get as much of the fluid out as possible. This is most effective in the first few days.

Later that evening after the procedure, you will still be draining and you will start to get a little sore as the numbing medication wears off. You may want to take some Tylenol or pain medication at this point if needed. Since you will still be draining the fluids, it’s important to make sure that you have towels on your bed so you don’t make a mess on the sheets (the hotels don’t like it when that happens.) The whole draining process is painless and just an inconvenience. How much you drain will depend on how many areas you are having treated. The fluid is tinted red because its been inside your body, and contains a very small amount of your blood.

Forty-Eight hours after the procedure, you may take the garments off to shower and launder the garment if needed. Please use caution when taking the garment off, as you may get light headed the first time the garment is removed. You may try to squeeze out or milk out any residual fluids that remain in the treated areas. This can be a bit uncomfortable so go slowly. You can use soap and water around the adits, but there is no need to scrub too hard. After showering, you will want to get the garment back on as soon as possible, since you will swell more without the garment giving pressure.

You will be the most uncomfortable and swollen for the first week and you will notice that you feel better each day. Around week 1-2 the swelling will become very firm. This firmness will be around for 1-3 months. Your body will send specialized cells to the area to begin breaking down this firm swelling. This process varies widely and can take 1-3 months and sometimes longer. The firmness will soften up at varying rates on different parts of the areas treated. So this means that you may have firm lumps of swelling for a period of time while you are healing. This is normal and will resolve. Since you will be swollen for 1-3 months, what you see early in your recovery is not the final results. It takes time for all of the swelling to go down; how long depends on how your body heals.

Around months 2-3 it is common to experience varying degrees of depression, the process is often slower than you want. Getting overly anxious about the results and lack of patience commonly leads to depression in some patients. It’s important to remember that the process of removing fat from your body is traumatic and takes time to heal. You will also experience areas of decrease sensation and even numbness, but this will resolve in time. Nerves recover at a very slow rate, so it can take up to a full year for normal sensation to be restored.

In most cases, you will see significant improvement immediately after your procedure, but since you will swell, the final results are not apparent until much later. Some say that the bulk of the swelling goes down within weeks, while others say it can take up to 3 months and even longer. You will have residual swelling/thickness of the tissue for up to 6 months after the procedure, although this is usually mild. But it can make you look uneven and potentially lumpy to some degree. In the majority of situations this will resolve, but it may take 6 months to 1 year.

Your results will continue to improve for up to a year as all the residual swelling resolves and the scar tissue under your skin matures. In the early months, it’s totally normal to feel lumpy and look somewhat uneven due to swelling. Keep in mind that there will always be some slight asymmetry. Our specialist works very hard to make everything even and smooth, but perfection is not realistic. Most people are very happy with their results, but you have to be realistic given your body type and genetics.

**Please be advised that if you are having more areas treated, you will be more sore and things will be a little more difficult for your recovery.

Expectations Regarding Results

Everyone wants to know exactly what they will look like after liposuction. Unfortunately, there are no guarantees and it is impossible to predict exactly how each individual’s body will heal. The truth is, everyone’s body is different and their body has different limitations and different healing potential. There are some things that we can evaluate to make an educated guess as to what the outcome will be, but there are no guarantees. Those that have realistic expectations tend to be much happier with their results. The goal of liposuction is improvement, not perfection. NO ONE IS PERFECT!! After liposuction, it’s normal to have slight asymmetries, and possibly mild dimples (similar to cellulite.) In most cases, no one will notice these imperfection other than the patient since they are looking at themselves critically. Keep in mind that we are removing in many cases large volumes of fat cells which are naturally round and we are trying to make the entire area smooth and uniform primarily by touch. This truly is an art, which our specialist is very good at, but there are aspects that are out of our control. Below are some of the limitations when considering your expectations.

Limitations

• Looseness of your skin.

  Usually the tightness of your skin prior to liposuction will be comparable to the tightness after the procedure, but the volume and size will be smaller. This is evident in many of our before and after pictures; even in larger patients, their skin usually retracts quite nicely. If you have very loose skin before liposuction, then your skin is likely going to be very loose after, but the volume of the area will be much less. Many individuals are happy with a reduced volume and bulk of a specific area which will allow them to fit into their clothes better. Some choose to use body shapers (spandex undergarments) to give the appearance that there is no loose skin. In contrast, if you have very tight skin before the procedure, then you will likely have tight skin after the procedure. If you are concerned about the looseness of your skin, then we recommend using the Smart Lipo Laser for an added skin tightening benefit.

• Dimpling and Cellulite.

  Liposuction is not meant to be a cellulite treatment. Many individuals also have very asymmetric fat deposits that may affect the outcome. With that said, many patients have reported an improvement in symmetry as well as decrease in cellulite. Most will see comparable dimpling to what it was prior to the procedure, although the distribution may be different. A small number of people may actually get worse cellulite after liposuction, although this is not common. The presence of cellulite puts you at a higher risk for dimpling after liposuction.

• Density of fat.

  Individuals that have very dense fat tend to see more dramatic changes than those that have less dense fat. I believe that when the fat is more dense, the skin is tighter and when the fat is removed the skin retracts quickly and more dramatic results are usually evident. These people usually put on weight quickly and their skin has not had the time to stretch out and begin sagging in many cases, others just have great genetics. In some circumstances when there is what feels like dense fat, it turns out to be very fibrous fat and is very difficult to remove. These people tend to see less results likely due to the abundance of connective tissue which has a significant bulk in itself. This is more common in men. When the fat is not very dense, the results are limited to how much the skin will retract. Some individuals that have lost a lot of weight or have been very heavy for long periods of time may have less dense fat due to the looseness of the skin. While we may be able to remove large volumes of fat on these individuals, they are limited on the tightening of the skin usually.

• Thickness of your skin.

  When your skin is very thin, dimpling is more likely to show through your skin. In contrast, if you have very thick skin, it is more likely to cover up any slight irregularities. Thickness of your skin is secondary to genetics as well as age. As you get older, skin tends to get thinner and looser.