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Liposuction Article 2

History for the Liposuction Patient

Patients are evaluated for risk factors including smoking, hypertension, heart disease, lung disease, diabetes, hepatitis C, and HIV. Patients with a history of clots in their legs or history of clots going to their lungs may need medications to “thin” the blood and will need medical clearance before the idea for liposuction surgery is considered.

Use of birth control pills or hormone replacement therapy increases the risk of blood clots and typically patients are advised to stop taking these one month prior to liposuction and one month after liposuction. All liposuction patients receive sequential compression devices for the lower extremities during surgery to help prevent blood clots or DVTs. Medications such as aspirin, non-steroidal anti-inflammatory agents like Ibuprofen and Naproxen, vitamin E, and fish oil should be discontinued 2 weeks prior to the liposuction procedure due to concerns of increased bleeding risk.

Patients who are significantly overweight (BMI greater than 30) have a higher risk for poor wound healing, infection, and blood clots. Patients who have hernias will need to have those hernias repaired prior to liposuction, or those areas with hernias should be avoided with the liposuction cannula.

Physical for the Liposuction Patient

Liposuction patients should be evaluated for hernia (umbilical hernia is the most common). Some patients have a lot of intra-abdominal fat, which cannot be addressed by liposuction. Thus, the patients who have higher overall bodyfat percentage are less likely to get a flat stomach with liposuction alone.

Leg, calf, and ankle liposuction recovery is longer than with liposuction of other areas of the body. Patient satisfaction is far greater with abdomen, sides, and back liposuction in most cases. Medial and lateral thigh as well as upper arm and chin liposuction also have high satisfaction rates.

A Comment about Skin Elasticity of the Patient

The patient must have adequate skin elasticity to allow for skin retraction after surgery. This factor is the most important element to good results aside from technical proficiency of the surgeon and the patient’s ability to follow the postoperative regimen of wearing the compression garment appropriately. If Dr. Hughes determines the skin elasticity to be less than ideal, other procedures like Bodytite or procedures like tummy tuck, thigh lift, or arm lift can be considered depending upon the location of the skin laxity. These procedures can typically be combined at least in part in a mommy makeover procedure.

Surface Irregularities, Dimpling, Contour Deformities

Dr. Hughes will point out any wrinkles, laxity, and surface irregularities, including dimpling. Dr. Hughes will endeavor to improve these items during the surgery through a series of maneuvers. However, the improvement will not be 100%, and patients should expect only 50 to 60% improvement. Some of these irregularities may require several different modalities to achieve improvement including liposuction, fat grafting, and Bodytite.

Cellulite and What to Expect

Cellulite is often noted in areas such as the hips, buttocks, or thighs. Cellulite is predetermined by genetics, so even thin women can develop the appearance. Patients should be aware that liposuction procedures do not address cellulite and may in fact worsen its appearance. Dr. Hughes will try to correct any dimpling or asymmetry. However, this is frequently difficult to achieve. The patient should be aware of possible persistent asymmetry, depressions, and dimpling after the liposuction procedure. In addition, some of the cellulite improvement procedures may need to be performed separately.