LIPOSCULPTURE TUMESCENT LIPOSCULPTING Posted in: Most Frequent Procedures

It is important that you read and re-read this page before you consider undergoing this surgery.

Liposuction is a plastic surgery for fat suction from parts of the body, which improves the body contour of a person. This surgery was first done successfully in France in 1982 and a year later in the United States. It has been performed in this city of Tijuana since 1984.
It was in June 1984, when I performed my first liposuction in Tijuana, at the del Carmen Hospital. The patient was a boy with a pronounced case of Gynecomastia (accumulation of fat in breast area so as to resemble a woman’s breasts). The results achieved were  magnificent. After that initial procedure, I was deeply motivated to continue with this method to aspirate fat from areas such as abdomen, hips, buttocks, thighs, saddle-bags, love-handles, flanks, back, waist , legs, knees, arms, neck, cheeks, and virtually any area that requires the help of liposuction.

The technique of liposuction was developed by French surgeons, who initially used vacuum pumps connected to plastic cannulae employed for aspiration in abortions.  The US  changed the metal tubes for plastic with rounded tips to prevent damage the internal tissues. The tube has an opening a centimeter from the tip through which the excess fat is suctioned. The tube is connected to a semi-rigid silicone- hose which in turn is connected to a liposuction apparatus, made expressively for this operations. Although there are several brands on the market, in our practice we have always used t heGrazer-Grams aspirator. It develops an atmosphere of pressure, which is equal to 10.33 grams per square centimeter or 14 pounds per square inch. This is the maximum negative pressure that we can obtain at sea level.

Originally, Liposuction was performed under general anesthesia. The zones to be aspired were injected with a substance, which contracted the blood vessels to reduce blood loss. In some cases nothing was injected. In the early days of liposuction, we generally removed  about 70% fat and 30% blood, thus limiting the amount of fat we could aspirate to approximately 2 liters at most.

The patient’s stay in mild cases was a night and in cases of substanial fat aspiration, up to two nights. It was a common practice for patients who had more than twos liters aspirated, to undergo auto-transfusions (re-infusing with the patient’s own blood which had been drawn a week prior to surgery)

Since the 90’s in Brazil and the United States began a variation to the original technique of Liposuction: it reduces the risk of general anesthesia, the time spent at the clinic, can be done in a short stay clinic under local anesthesia and a mild intravenous sedation, and bleeding is surprisingly less: 0 to 5% in some cases.

This variation is called Tumescent Liposuction. It is so named because the area that is being aspirated is infiltrated with a significant amount of saline and anesthetic solution, causing swelling or tumescence of the area, thus temporarily swelling the region, shifting the blood to the periphery, resulting in a suction of almost exclusively fat and of course, some of the infused liquid, which is recovered partially.

The main advantage of tumescent liposuction is that it does suctions large amounts of fat with minimal blood loss, which makes possible a speedy recovery and a maximum of aspirate with patient safety so the patient can go home with fewer symptoms. The care after remains the same.

Today we call the technique Liposculpture, a term that we consider synonymous with Liposuction or Suction Assisted Lipectomy or SAL, Fat Aspiration, etc. Liposculpture is a term that better denotes the function of this procedure, rather than describe how it works.

It is not necessary to use a suction machine and we can use large 60 ml syringes, which are adapted to new, smaller cannula with one to three holes near its tip, as it has seen less tissue damage with similar results in suctioning like those of larger caliber. The advantage of using syringes is that we can re-inject the previously washed and filtered aspirated fat in a sterile way, to other body parts like thighs, buttocks, face wrinkles, lips or frowns, and so on.

Most cases of Liposculpture are performed under regional anesthesia causing numbness  from the waist down. This promotes a better and more comfortable recovery.The patient is discharged  the same day. When the patient comes from the U.S., I prefer to leave the patient in the hospital overnight ( click To my Patients who live outside Tijuana).

This surgery takes approximately 1 to 3 hours, depending on the areas to be worked. The recovery time takes approximately 5 to 10 days depending on the number of areas aspirated.

The results have always been good, both mild and moderate cases and larger fat deposits, too. However, the best results occur in healthy patients with normal blood pressure, non smokers, and those in whom the skin tension is firm, have little excess skin and minimum wrinkles.

It is also important to mention that those who follow the indication of the use of elastic compression garments, highly recommended after any liposuction initially for 6 days without removal, and then removing for showers every other day. These garments are elastic, washable and very durable, there are garments for neck and face, chest compression vests, waist binders for the abdomen, pants with stripes and double zips with open crotch for added convenience while being used after liposuction of the abdomen, hips, waist, thighs, buttocks and knees, and compressive elastic bandages or boleros for suctions of arms and legs. These garments must be worn by at least for 21 days. The use of such garments is 50% of success in Liposuction.

My favorite Liposculpture comprfession garments are Marena (Marena group inc.) (http://marenagroup.com/ ) or Veronique (http://designveronique.com/cgi-bin/ic/dv2/postsurgical.html) You can order them online or I can order with a local representative here in Tijuana for you.
Below are some important pointers regarding “before and after” liposculpture surgery:

BEFORE SURGERY:
1. Order a compression garment that you should use for 21 days after the operation. In the office we will give you more information on how to get it. (If you cannot order for your garments online, it can be ordered  through our office).
2. Do not take aspirin or aspirin products for 2 to 3 weeks prior to surgery. (Click Non recommended Medicines for more information.)
3. For three consecutive nights before surgery thoroughly wash the the parts of the body to be operated on with Isodine foam (Betadine in the US) shampoo. Your pharmacist may suggest an alternative product if you are unable to find it.
4. Do not eat food or drink any fluids  from 12 PM the night before surgery
5. For your own convenience, bring loose comfortable clothes with zippers or buttons.
6. On the day of your surgery, bring your compression garment.

AFTER SURGERY:
1. Go directly home and remain at rest for 24 to 48 hours. You may require assistance in the first week after surgery.
2. You may get up to use the toilet and for  meals.
3. The first day at home you should take sips of fluids, gradually increasing to a soft diet. If you do not have nausea, you can eat normally.
4. Place an absorbent blanket on top of the bottom sheet of your bed to absorb the drainage from the small incisions in your skin. This occurs during the  first two days following  surgery.
5. Do not remove your compression garment(s) for 6 days. Thereafter, you may remove the compression garment(s) for bathing only.
6. Bathing every second day, in tepid water, is permitted after 6 days. Do not use hot water as this may cause tissue damage during the healing process.  After12 days, you may bathe daily.
7. Your first follow-up appointment will be on the 7th day after surgery. Stitches will be removed on Day 10.

To view some cases of this surgery click Photo Gallery

Any questions before and after your surgery may be answered in person by calling the office, 684-2551  (US: 619-730-1917) or my cell 664-283-0976 or click Contact us for more information.

I wish you an excellent experience in Plastic Surgery and a speedy recovery.

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