- Stop taking aspirin and anti-inflammatory drugs for at least two weeks before surgery.
- Women may be asked to stop taking any oral contraceptive pills for one cycle before the operation, when undergoing more extensive procedures.
- Patients with anemia (a low red blood cell count) may be asked to take iron supplements before the operation.
- Every patient will be asked to sign a consent form, which confirms that they are fully aware of the risks, benefits and possible alternatives to the procedure.
During the operation
Dr. Brenner will mark out lines on your body immediately before surgery in the surgical holding area. These will indicate the exact areas to be targeted during the liposuction procedure. Photos of the markings, and frequently the entire body may be taken at this time.
Anesthesia – Most patients will have a general anesthetic for their liposuction procedure. Liposuction may last from 1 to 4 hours, depending on the extent of the planned operation. A local anesthetic may be used when liposuction is done on very small areas.
One of the following liposuction techniques may be used:
- Tumescent liposuction – several liters of a saline solution with a local anesthetic (lidocaine) and vessel-constrictor epinephrine (adrenaline) is administered subcutaneously (below the skin) in the area that is to be suctioned. Epinephrine helps minimize bleeding, bruising and post-operative swelling. The fat is suctioned out through small suction tubes (micro-cannulas). This is the most common technique for liposuction. The amount of liquid pumped into the area may be up to three times the amount of fat to be removed. This volume of fluids creates a space between the muscle and the fatty tissue, allowing more maneuverability for the cannula.
- Wet liposuction – a small amount of fluid with less volume than the amount of fat to be removed is injected into the target area. The fluid is similar to the one used in tumescent liposuction and minimizes bleeding and bruising. The fluid helps loosen the fat cells. The fat cells are suctioned out.
- Super-wet liposuction – this technique uses less liquid that tumescent liposuction; about the same amount of liquid as fat to be removed. Otherwise, the technique is very similar to tumescent liposuction. The patient may need a separate anesthetic.
- Dry liposuction – no fluid is injected before fat is removed. This method is seldom used today. There is a higher risk of bruising and bleeding.
- Power-assisted liposuction (PAS), also known as Powered liposuction – uses a specialized cannula with a mechanized system that rapidly moves back-and-forth, allowing the surgeon to pull out fat more easily. It is similar to traditional liposuction, but the surgeon does not need to make so many manual movements, as in other methods.This method may sometimes cause less swelling and pain, and may allow the surgeon to remove fat with more precision, especially in smaller areas.
The liposuction cannula – this is a stainless steel tube, which is inserted through an incision in the skin and is used to suction the fat.
The liposuction microcannula – is a very small cannula with an inside diameter of less than 3 mm.
The size of the cannula can influence how smooth the skin is after liposuction. Large cannulae tend to create irregularities more commonly than micro-cannulae. Large cannulae are more frequently used for total-body liposuction.
After an area has been prepared for treatment, a small incision is made (sometimes several, depending on the size of the area), and a micro-cannula is inserted into the incision. The micro-cannula is attached to a special vacuum machine. The micro-cannula first loosens and then sucks the fat out of the area.
After your operation: -Bruising and swelling are common after liposuction. Dr. Brenner will likely dress you in some type of compression garment after the operation to help minimize swelling. For the first 24 to 48 hours after the operation, it is not unusual to experience a small amount of oozing from the access incisions. This fluid represents some of the tumescent fluid that is still working its way out of the tissues, and is to be expected. This is just the beginning of your healing process.