Body Procedures, The Center for Plastic Surgery : Washington DC

Liposuction

Tummy Tuck (Abdominoplasty)

Leg/Buttock Lift

EndermologieŽ

LIPOSUCTION

Liposuction was developed in the 1980's to help patients who have unwanted areas of fat accumulation beneath the skin that are not responsive to diet or exercise. Liposuction is a contouring procedure, not a substitute for weight loss. It can be an adjunct to both weight loss and a good exercise program.

The best candidates are those who are at or close to their ideal body weight and size, yet still have persistent areas of unwanted fat accumulation. Liposuction cannot change underlying bony dimensions, but it can improve contour significantly when subcutaneous fat is the problem.

The most common areas that benefit from liposuction are the abdomen, hips and thighs, although other areas can be treated. If more than one problem exists, liposuction may be combined with other procedures, such as abdominoplasty, for the patient's maximum benefit.

Liposuction is a safe procedure when appropriate guidelines are followed in planning for the possible need for blood transfusion or fluid replacement. Such planning depends upon the volume of fat to be removed.

During liposuction, the surgeon uses a small metal tube (cannula), which is connected to a powerful suction machine. The surgeon inserts the cannula through a small incision into the area of the body adjacent to the unwanted fat. The fat is removed (aspirated). Because the incisions and the cannula are small, the resulting scars usually are inconspicuous. Infiltration of physiological saline solutions with other medications allows easier removal of the fatty tissue, less blood loss and added comfort post-operatively.

After liposuction, you will be placed in an elastic support garment, similar to a girdle, while you are still asleep. This garment will cover and compress the treated areas to limit fluid accumulation and provide gentle, even pressure to assure a smooth final contour. You will wear this garment continuously for three weeks, except to bathe. There may be considerable bruising and swelling after liposuction. The most common complication is occasional skin rippling. These conditions will improve considerably in the first three weeks, but the final result can take up to three months. Most patients will be able to resume all normal activities, including walking and driving, in five to seven days. Strenuous exercises should be postponed for three weeks.

A great source of additional information and true stories from actual liposuction patients is www.liposite.com.

TUMMY TUCK (Abdominoplasty)

After pregnancy or significant weight loss, the skin across the abdomen may become loose or excessive. When this happens a surgical procedure called abdominoplasty can be done to improve body image and self-esteem. Tightening loose muscles and removing excess skin and fat are integral parts of abdominoplasty.

While abdominoplasty usually is an elective procedure, the condition is so extreme in some cases that the skin hangs down over the beltline or pubic area (pubis), causing severe skin irritation or even skin breakdown. When this happens, abdominoplasty is a medically indicated procedure and may be fully or partially covered by insurance.

In abdominoplasty, the surgeon makes a horizontal incision low on the abdomen, just above the pubis, separating the excessive skin from the underlying muscle layer of the abdominal wall. This allows the surgeon to examine the muscles and their covering layer and to repair any weaknesses or hernias.

Achieving a flat abdomen usually requires repairing this layer. Next, the surgeon pulls down the abdominal skin and removes the extra portion. The surgeon inserts small drain tubes to remove any blood or fluid that collects after surgery, and these remain for three to five days. While you are still asleep, you will be placed in a special garment to provide gentle, even pressure. This helps prevent fluid accumulation in the surgical area and protects the deeper muscle repair. In some cases where laxity is not extensive a more limited procedure known as mini-abdominoplasty may be more appropriate.

Three to five days after surgery, you will return to the office for removal of the drain tubes. You will continue to wear the garment for three weeks except to bathe. While you should avoid strenuous exercises or athletics during this time, we will encourage you to walk. Walking will decrease the risk of complications. Within seven to ten days, most patients will be comfortable enough to resume light activities. The return to a normal level of activity will take about three weeks.

The incisions from abdominoplasty are easily concealed, even by underclothing or swimsuits.

Complications from abdominoplasty are uncommon. There are rare instances of skin damage that can extend the healing period.

LIFTING OF THE LEGS AND BUTTOCKS

The skin on the legs and buttocks is particularly prone to stretching and loss of tone. Unlike the abdomen, however, these areas have no underlying hernias or structural weaknesses, and the problem is strictly one of excess skin. Surgical removal of this skin and tightening the remaining skin can achieve a more youthful appearance. Body contours can be improved by surgical removal of excess skin and fat.

The surgical incisions and resulting scars vary from area to area, but every effort is made to place them in locations where they are concealed. This is easier on the buttocks than on the legs, where they may be more noticeable.

Recovery is similar to that of abdominoplasty. After the surgery, you will wear a specifically designed supportive garment for a length of time that will depend on the procedure done.

Complications are rare with these procedures. Occasionally there maybe more noticeable scars than would be ideal. In rare cases, the skin may stretch causing some recurrence of the problem.

ENDERMOLOGIEŽ

EndermologieŽ is an innovative massage technique which has been used in Europe for the past 10 years and only recently introduced in physicians' offices in the United States. This nonsurgical approach to body contouring is used to improve circulation, skin tone, and help reduce the appearance of cellulite. EndermologieŽ is not a replacement for liposuction but is many times performed in conjunction with liposuction to enhance results.

EndermologieŽ is performed by using a mechancial therapeutic massage device which is assisted by suction and rollers. Treatments last approximately 35 minutes and are performed one to two times per week. We recommend a minimum of 15 sessions. The endermologieŽ treatment plan involves patient commitment to a healthy lifestyle with recommendations for water intake, exercise and diet which can greatly effect the outcome of the treatments. We have seen many patients who have seen significant improvement with these treatments, however, some have not. It is difficult to predict who will benefit from these treatments.