What is liposculpture?
Liposculpture involves the combination of liposuction and fat grafting techniques. The fat grafting using excess fat removed from some other region of the body through the patient's own liposuction to "sculpt" the body, to fill, and shape sagging increase structures, depressions, or areas with little fat.
Plastic surgery
How is surgery
Plastic surgery
First is infiltrated Klein solution - comprising saline and epinephrine - to minimize the chance of bleeding and, consequently, surgical trauma. The liposuction cannulas are inserted through the skin and reach the adipose tissue (layer that comes after the skin), where aspire - through a vacuum system - localized fat. The points at which the cannulas are inserted vary depending on the patient's anatomy and the technique used by the surgeon.
Liposuction can be done under general anesthesia, epidural or local depending on the number of regions covered. If anesthesia is general, there is the need for endotracheal intubation and use of devices that help breathing. In general, liposuction scars are approximately half a centimeter, but can be almost unnoticeable with time, and do not cause nuisance.
"Then the fat is treated - is made the removal of fat cells broken, blood and anesthetic - and fat and grafted in a new location," explains plastic surgeon Eduardo Andrade Filho, the nature area, in Campinas (SP ). "The graft is placed through thin needles to the desired location, giving volume and form to the location." The surgical procedure lasts on average two hours.
Doctors who can perform this surgery
The plastic surgeon Andrew Eyler, a member of the Brazilian Society of Plastic Surgery, explains that legally all doctors can perform liposuction. However, it is indicated that the patient seek medical plastic surgeon, professional able to perform the technique. who has training and adequate preparation, ie specialty in plastic surgery.
Body parts that can be submitted to liposculpture
Liposuction can be performed in any region there is located fat. "At first, anywhere can graft the fat, the areas of greatest demand for application are fat buttocks, face, hands and breasts," explains Andrew Eyler. The expert explains that it is possible to graft the fat sucked in different regions of the body in just a procedure, but it takes care not to excessively increase the time of surgery.
If the patient decides to treat different areas in different surgeries, a minimum interval of one month between surgeries will be required. If you want to treat the same area a minimum of six months until the swelling disappears region it is necessary.
Best results of liposculpture
According to Andrew Eyler, the fat grafting face has more impactful results, followed by the rejuvenation of the hands and increase glutes.
According to the plastic surgeon Eduardo, the best results occur when fat is located under a region of skin elasticity and good without excess. Places of localized fat, but with increased skin laxity should be accompanied by the local skin removed.
Amount of fat removed
Andrew Eyler explains that the amount of fat removed depends on the biotype of each patient and therefore, is highly variable. The maximum amount removed is up to 7% of body weight in the wet surgeon (performed with solution infusion decreases bleeding and anesthesia region) and 5% in the dry operation (without the infusion of the solution), according to the Council standards Federal Medical.
Indications of liposculpture
liposuction
Liposculpture is indicated for patients with localized fat accumulation and areas that need filling due to lack of fat tissue. "It is preferable that these people are within the normal weight, generating more satisfactory results," explains Andrew Eyler.
Contraindication to liposculpture
previous pathologies such as heart disease, lung disorders, diabetes, hypertension, anemia, among others, uncontrolled, make the risky procedure. In the specific case of uncontrolled diabetes can affect the healing process. "This condition can lead to partial or total obstruction of the vessels, which impairs tissue oxygenation and, consequently, the formation of collagen and elastic fibers," explains plastic surgeon Márcio Castan, a member of the Brazilian Society of Plastic Surgery. Still, it is known that the majority of diabetic patients have arterial diseases, with greater chance of developing tissue necrosis.
"This procedure should be performed in patients with accumulation of localized fat and not seen as a slimming treatment, as liposuction should not take more than 7% of body weight, i.e., if the patient weighed 60 kg, should not liposuction more than 4200ml, "says Márcio Castan. In general, who should not be subjected to liposuction are patients who are considering this procedure as a weight loss measure. psychological disorders such as depression or any body dimorphism, for example, anorexia, also contraindicate liposuction.
care prior to surgery
Any surgery should be preceded by some details. These details consist primarily of a correct indication for surgery to be performed, clarifying the patient or legal guardian about the possibilities of results and the risks of a surgical procedure / anesthetic and a preoperative with relevant tests for each case.
Even before the surgery the patient should, if possible, to follow some measures to suspend some medications that can harm the surgery, for example, tablets containing acetylsalicylic acid - that alter blood clotting - among others, always remembering that any medication that is being used should be surgeon science. The contraceptive pill should be discontinued, if possible, one month in advance because studies point to its thromboembolic potential.
It should be stopped smoking 30 to 60 days in advance, as it has direct influence on healing. With regard to food, there are some foods that should be avoided by interfering in bleeding, such as garlic and horse chestnut.
It is essential that the patient tell the doctor about any kind of infection in the days preceding the procedure, as the largest source of surgical infection is the patient.
previous exams to liposculpture
In general, laboratory tests are required, such as complete blood count. It will be evaluated mainly the presence of anemia, infections, platelet count changes. It is considered prudent to apply the sodium dosages, potassium, urea and creatinine in order to assess renal function. Calls is also a complete coagulation to see if any blood clotting disorder.
After a certain age it is advisable to apply for fasting glucose to assess whether the patient has diabetes. In some cases it may be necessary to take common request urine with urine culture, with which it is possible to diagnose a urinary tract infection.
For older patients, other exam become necessary, as the electrocardiogram and chest X-ray to assess cardiac and pulmonary function. It is an option to ask women of childbearing age beta-HCG to rule out possibility of pregnancy.
There are also several tests that are specific for each surgery. In the case of liposuction, total abdominal ultrasound and abdominal wall hernias can detect and intra-abdominal pathology that can cause confusion in a possible operative diagnosis. "For example, if the plastic surgeon perform an abdominal liposuction and do not know that the patient has gallstones, abdominal cramps postoperative can induce to believe a violation of the cavity by liposuction," says Márcio Castan. "It is prudent to request specific examinations according to pre-existing conditions of the patient, in order to know if this disease is under control and the patient may or may not be subjected to the surgical procedure."
hospital length of stay
Generally liposuction does not require hospitalization, ie, the patient can go home after spending time in a post-anesthetic recovery room, staying in the hospital between 12 and 24 hours. Still, such surgery should be performed in a hospital setting, always making sure the total security of the establishment.
Postoperative liposculpture
Until it can achieve the desired result, several phases are faced by the patient. Thus, edema (swelling), "stains" accumulation of blood in the subcutaneous tissue hypersensitivity in some areas, insensitivity other, are common to all patients. Some patients present these phenomena with greater or lesser intensity than others and are solved, in general, approximately 21 days. A short period of dissatisfaction may occur in the early days, due to the transitory aspect, usually from the anxiety in reaching the final result as soon as possible.
modeling girdle
The use of postoperative brace, or modeler, is indicated by some physicians and not by others. The modeler can play an important role in the final result of liposuction, but is not a result satisfaction guarantee. It will help to "compress and reposition" the detached tissue with liposuction to the place where it should stay. The use of postoperative belt is constant and is removed only for bathing during the first 30-45 days.
Postoperative medication
Just like any postoperative most concern is the pain and possible infection. Then this period indicates the use of analgesics, depending on the degree of pain presented by the patient and prevention of infections and antibiotic. It is still wise to evaluate the individual thromboembolism risk. For patients with increased risk can make use of anticoagulant medications postoperatively.
Physical exercises
Hiking progressive, according to the arrangement for this purpose are fully released, but physical activity, in general, should be avoided for a period of 21 to 30 days, varying how the patient responds to surgery and the amount of fat was removed .
Risks related to liposculpture
As with any surgical procedure, liposuction is also subject to possible complications. "These complications can range from milder complications such as prolonged swelling, seroma (which is the accumulation of fluid in the space that was created by liposuction), infections to more serious complications ranging from skin necrosis or grafted fat, which can lead to an abscess, perforation to viscera and pulmonary embolism, "says plastic surgeon Márcio Castan.
The specific complications of liposuction are related generally with poor results that may be obtained, such as:
- Irregularities (wrinkled skin, wavy, uneven);
- Basic Problems such as depressions or deformities, unresolved;
- Basic problem Overcorrection (if the butt becomes larger than expected, for example)
It is known that liposculpture went wrong when after a period of adaptation of the body to the surgical trauma did not obtain the idealized result and designed initially.
Lymphatic drainage helps to reduce swelling, prevents fluid buildup in the space created by liposuction (seroma), activates blood circulation and relieves pain. Further, by manual lymphatic drainage or apparatus, it is possible to assist in the removal of hematoma, accelerate the process of wound healing and postoperative recovery, as well as to minimize undulations and irregularities prevent the onset of fibrosis that may arise in the post- op.
"Lymphatic drainage should be done in a way that stimulates the overall lymphatic circulation: in the operated area, should be more detailed and targeted, slow and gentle way in order to reduce the inflammation caused by surgery," says plastic surgeon Marcio Castan.
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