WHAT IS LIPOSUCTION (LIPOSCULPTURE / LIPOLYSIS)?
Liposculpture and Lipolysis are synonyms for liposuction. That is, they are different terms for the same procedure.
Liposuction is the suctioning of excessive, localised fat deposits to reshape disproportionate or unsightly contours of the body, producing pleasing body lines. Body shape is basically genetic in origin and is reflected in both our musculo-skeletal frame and the distribution of overlaying fat. There is also a strong hormonal influence. Liposuction succeeds where diet and exercise fail.
The definition of areas suitable for liposuction are ‘Those unsightly, localised deposits of fat, genetically determined, that do not go with diet and exercise’.
HOW IS IT DONE?
Tiny, well placed ‘nicks’ are made in the skin, through which tumescent fluid (a combination of saline, local anaesthesia and a vaso-constrictor) is introduced into the fat. The fat is then suctioned using a cannula (suction tube) to contour the area.
Good results require attention to detail from the time of examination at the initial consultation through to performance of the procedure itself. The operator must have an artistic eye for ideal body contours and, prior to operation, should mark the areas accurately. In performing the procedure, care must be taken to remove the right amount of fat from each area, since the purpose is to produce aesthetically pleasing contours.
Removal of more fat from any area beyond what is necessary to produce an aesthetic shape will produce an unattractive flat contour, or worse, a concavity (scooped out appearance). Excessive fat removal also causes dimpling or gross irregularity of the area.
Over the years Dr. Fox has been referred patients by plastic surgeons, cosmetic surgeons as well as by patients referring their friends and family. Part of his practice is restorative procedures to correct poor results of liposuction performed elsewhere.
A special medical compression garment is worn for several weeks after the procedure to support the newly shaped contours and aid the skin to retract smoothly and firmly. When performing liposuction of multiple areas, the sterility of the operation area and patient safety and comfort are best achieved by using light general anaesthesia administered by a specialist anaesthetist and under sterile operating theatre conditions. The procedure is performed in hospital on a day surgery basis with no overnight stay. The duration of the procedure is relative to the number and size of the areas to be reshaped.
Small areas, such as ‘double chin’ and small body areas can be comfortably and suitably done under sedation and local anaesthesia in our rooms.
THE VARIOUS TECHNIQUES
Do not be confused by the supposed different techniques of liposuction. They all aim for (and should produce) the same result: improved contours. More important than any device is the experience, skill and care of the liposuctionist.
Tumescence involves infiltrating saline into the area prior to suction and is an integral part of liposuction. Dr. Fox was at the first lecture on tumescence in Philadelphia in 1986, and has used the technique since then. Only modest amounts of saline are used and are not associated problems.
The infiltration of very large amounts of saline is necessary if the procedure is performed under local anaesthesia. This ‘mega-tumescence’ is an exaggerated form of tumescence. By infiltrating such large volumes of saline, the areas to be reshaped can be distorted, thus obscuring the natural shape and making it more difficult to produce a good result. In the past these large volumes have produced fluid overload problems and the amount of local anaesthetic used have approached toxic levels.
During mega-tumescent procedures, the patient is sometimes assisted to the standing position in an attempt to assess progress. The sedated condition of the patient can markedly limit the supposed value of the manoevre. More importantly the sterility of the procedure can be severely compromised.
Mega-liposuction (not to be confused with mega-tumescence) is the removal of more than 6 litres of fat at one time. The American Academy of Cosmetic Surgery recommends that it be restricted to clinical research only. It can be a dangerous technique.
Ultrasonic liposuction involves liquefying fat with ultrasound. The liquefied fat is then removed by suction. Dr. Fox studied the French technique in Paris in 1996 where he had contact with reputable surgeons using ultrasound (including an associate professor of surgery), and became the first in Australia to offer the French-developed technology (a more primitive Italian version of ultrasound technology has had associated problems).
This technique fell into disuse simply because it took twice as long as traditional liposuction.The latest machines are more powerful but, as with the earlier versions, often no real advantages over the standard technique.
The use of external ultrasound to reduce fat deposits has not established itself as a reliable technique.
Laser Assisted Lipolysis (liposuction). Dr. Fox was one of two practitioners to introduce this technique into Australia, having been trained by Professor Nicola Zerbinatti in Milan. The results were disappointing except for small areas such as the ‘double chin’. A more powerful machine is now available, which Dr. Fox believes still does not produce results comparable with traditional liposuction.
The power assisted cannula and the oscillating cannula are new devices that lessen the physical effort for the surgeon. They vibrate at high speed and help to loosen the fat tissue so permitting easier and more gentle cannula fat removal and minimizing disruption of surrounding tissue and fine vessels.
The initial recovery period ranges from 24 hours to 7 days, depending upon the area/s addressed. To return to work after one week is usual.
When performed by an experienced surgeon, in appropriate operating conditions, liposuction is one of the safest cosmetic procedures in the world. Liposuction can reshape virtually the entire body, and alter contours that diet and exercise cannot change. A light general anaesthesia makes for a comfortable experience and maximizes results. Recovery time is brief and initial results can often be seen as early as 1 – 2 weeks after the procedure with progressive improvement with the passage of time.
TRAINING AND EXPERIENCE
Dr. Fox has been performing liposuction since 1986. He was trained by three of the original American pioneer surgeons (Richard Dolsky, Julius Newman and Garry Fenno) who were in turn trained by the populariser of liposuction, French gynaecologist Yves Gerard Illouz. He introduced the French technique of ultrasonic liposuction to Australia and laser lipolysis.
He believes that the training, skill, experience and a caring attitude of the liposuctionist are far more important than the particular technique or device used. A classic case of the workman being more important than the tools he uses.
Dr. Fox has performed liposuction on 18 doctors to date.
Before & After Gallery
Please note that all the Photographs in our before and after gallery for Liposuction (LIPOSCULPTURE / LIPOLYSIS) are actual patients of Dr.Bruce Fox and the photographs have not been enhanced or altered in any way. This is the only procedure which has occurred. For more information about Liposuction please contact Dr Bruce Fox’s rooms.