When Your Bulge Won’t Budge: Liposuction for the Treatment of Unwanted Fat

The most rewarding part of diet and exercise is the physical changes your body experiences. However, sometimes these aren’t enough to tone and shape those stubborn body parts like the thighs, abdomen, buttocks and arms. These pockets of fat that are resistant to a healthy diet and exercise can be removed through liposuction, a safe and effective treatment option.

Speaking at the American Academy of Dermatology’s (AAD) Derm Update 2002, dermatologist Bruce E. Katz, MD, Associate Clinical Professor of Dermatology, College of Physicians and Surgeons, Columbia University, New York, New York, discussed liposuction and the latest techniques that make this the most popular cosmetic procedure performed in the United States.

In the 1980s, tumescent liposuction was developed by dermatologists and dermatologic surgeons to maximize patient safety by employing local anesthesia administered with controlled volumes of fluid. Tumescent liposuction using local anesthesia offers the benefits of fewer skin irregularities, less bleeding, reduced bruising, and a faster recovery. The procedure is also designed to be performed as an outpatient procedure, thus, potential complications from general anesthesia and a costly hospital stay can be avoided.

“When performed using local tumescent anesthesia, liposuction is one of the safest surgical procedures performed in aesthetic medicine today,” said Dr. Katz. “The use of tumescent liposuction allows dermatologists to safely and efficiently remove both deep and superficial excess layers of fat with little discomfort, more rapid healing and improved cosmetic results.”

The latest development in liposuction is power liposuction which refers to the advanced instruments used to perform the surgery. Rather than manually pushing a cannula, the thin stainless steel suction instrument used in liposuction, through excess fatty tissue to extract fat, power liposuction uses a mechanical cannula which removes fat tissue by a reciprocating, or rapid back and forth motion. In most cases, this form of liposuction can be performed in less than one hour.

In fact, two recent studies published in Dermatologic Surgery demonstrated that power liposuction has significant advantages over traditional tumescent liposuction. In addition to increasing the amount of fat removed per minute, power liposuction was also shown to increase surgical precision and safety, and reduce post-operative downtime. Power liposuction was also found to have a much smaller touch-up rate than traditional liposuction, meaning patients very rarely had to return to the office after the initial treatment.

“One study even showed that with the use of tumescent local anesthesia, patients could actually stand up at the end of the procedure in order to have treated areas fine-tuned. Digital photos of the treatment areas could also be taken and shown on screen to the patient who could see the surgical results from all angles,” said Dr. Katz. “When patients are alert during the procedure, and able to see the results before they walk out of the operating room, it improves the effectiveness of the procedure as well as the patient’s satisfaction.”

Another unanticipated result of power liposuction was the reporting of an increase in breast size by women who have undergone the procedure. “In a recent study, more than 30 percent of patients who have had power liposuction noticed a significant increase in breast size and found their breasts to be fuller and firmer, often increasing one cup-size in their bras,” said Dr. Katz. “This phenomenon is likely due to a relative change in the balance of adrogenic and estrogenic fat cell receptors that can increase breast size.”

Patients should keep in mind that all surgical procedures carry some risk. However, the risks associated with liposuction can almost all be traced back to a physician adopting an overly aggressive approach to the procedure.

To further reinforce the goal of patient safety, the AAD was the first medical specialty to develop Guidelines of Care for Liposuction. These conservative guidelines for physicians and patients include the following:

* Liposuction should not be performed under general anesthesia.

* It should be performed on healthy individuals.

* Liposuction is not a procedure for the treatment of obesity and should not be used to extract large amounts of fat.

* Liposuction should not be performed along with other procedures.

“Dermatologic surgeons are trained and experienced in the use of a wide range of surgical, cosmetic, reconstructive, and non-surgical methods to repair and improve the function and appearance of skin anywhere on the body, and as skin surgery experts, we are uniquely qualified to treat the fatty layer of skin,” said Dr. Katz. “However, as with all surgical procedures, patients should do their homework and ask their dermatologist questions about what they can expect before, during and after the procedure.”

The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of over 14,000 dermatologists worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the AAD at 1-888-462-DERM or www.aad.org.

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