From Dr. Federico Macaya


types of anesthesia
The Surgery
After your surgery

Suction-assisted lipectomy -also known as liposuction, fat suction, or suction lipectomy- is a technique to remove fat deposits from specific areas of the body, including the chin, neck, and cheeks; the upper arms and above the breasts; the abdomen, buttocks, hips, and thighs; and the knees, calves, and ankles. Liposuction is not a substitute for weight reduction, but a method of removing localized fat that doesn't respond to dieting and exercise.

Suction-assisted lipectomy may be performed in my office, in a outpatient surgery center, or at the hospital. It's usually done on an outpatient basis. Extensive procedures may require a hospital stay overnight.

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If your procedure is not too extensive liposuction can be performed under local anesthesia, which numbs the area, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort. When liposuction is performed in larger areas or to treat several sites, you'll probably have general anesthesia. In that case, you'll sleep through the operation.

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THE SURGERY                  

Suction-assisted lipectomy usually takes an hour or two, but the time required may vary considerably- from thirty minutes to several hours, depending on the amount of work you're having done.

To begin the procedure the area to be treated is infiltrated with large amounts of a saline, xilocaine, epinephrine and bicarbonate. This is known as tumescent technique and it helps to avoid bleeding as much as possible. A small incision is made,  to allow the insertion of a hollow tube called a cannula. The opposite end of the cannula is attached to a machine that creates a strong vacuum. The surgeon manipulates the cannula deep within the fat layers under the skin, breaking up the fat and suctioning it out. Sometimes additional incisions are needed to remove all areas of fat.

If you've had local anesthesia, you'll feel some vibration and friction during the procedure. You may also feel a stinging sensation as the cannula moves closer to the muscle.

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After surgery, an elastic dressing, girdle, or body stocking must be worn over the treated area to control swelling and bleeding, and to help your skin shrink to fit your new contour. You may need to wear this garment continuously for a month.

Don't expect to look or feel great right after surgery. You'll even be heavier for a while, because of the extra fluids you've been given. The suctioned areas will be swollen and bruised, and you may feel a burning sensation. The pain can be controlled with medications , though you may still feel stiff and sore for a few days. You may temporarily lose all feeling in the suctioned area; don't worry-it will return.

It's not unusual to feel depressed in the days or weeks following surgery. Try to keep in mind that this is normal and will subside as you begin to look and feel better.                                     

The stitches will be removed in five to ten days or dissolve, and you should be back at work 2 - 3 days, or as much as two weeks  after your surgery. When you resume activity depends on the extent of your procedure and  how you feel .

While most of the swelling and discoloration will be gone a month or two after surgery, some swelling can remain for six months or more.

Suction-assisted lipectomy is a highly effective technique for giving you a new body contour with very little scarring. The results are permanent, providing you eat sensibly and exercise regularly. If you do gain weight, you'll probably gain it more uniformly throughout your body, not just in the former "bulges."

Most patients are very satisfied with the results of their liposuction-they feel more comfortable in a wide variety of clothes, and more at ease with their bodies. As long as your expectations are realistic, you should be happy with your new shape.

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Liposuction is normally safe, nevertheless, in rare instances the procedure may cause severe trauma, infection, fluid accumulation, rippling or bagginess of the skin over the treated area and pigmentation changes (such as brown spots) that may become permanent if exposed to the sun. Asymmetry (uneven contour or shape) sometimes requires a second procedure.

After surgery the patient must stay at least 10 days in Costa Rica. I recommend the Las Cumbres Inn where you will receive personal attention, required medication and transportation to and from surgery. I visit my patients at Las Cumbres frequently following surgery to check on your recovery.

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