Surgery Instructions – Liposuction

Download the Liposuction Instructions

LIPOSUCTION

MEMORIZE THIS PAPER PRIOR TO SURGERY

What To Expect from Liposuction

Liposuction, one of the most popular of all cosmetic surgeries, is a procedure that removes localized fat bulges, thereby improving your figure. The method was popularized in France in the 1970’s, and has been used on thousands of patients in this country with excellent results and a low incidence of complications.

Liposuction is usually performed on an outpatient basis at the Highland Park Plastic Surgery Center. If extensive correction is necessary, Dr. Toledo may wish to have you transferred to an after care facility for a planned overnight stay.

Is Liposuction For Everyone?

The quality of your skin is vital in determining the aesthetic outcome of the liposuction. Youthful elastic skin will contract easily, usually leaving a smooth surface. Older persons, or those with very poor skin tone, may be poor candidates for liposuction alone. They may require surgical removal of excess skin (for example: a facelift, abdominoplasty, or buttocks lift) done in conjunction with or instead of liposuction.

It is important to understand that liposuction is not a cure for obesity. This procedure is more appropriate for persons with localized fat bulges that are inherited and remain, despite weight reduction and exercise.

Liposuction is a surgical procedure that successfully removes localized excess fat around the face, neck, waist, abdomen, hips, buttocks, thighs, knees, calves and ankles. It is also ideal for removing accumulations of excess fat in the male breast.

The results of liposuction are permanent. Fat cells that are removed do not return. Weight may be gained in the area treated, but usually in the same proportion as in the rest of the body.  If there is weight gain following surgery, it is possible to have some increase in the area treated, but usually other areas of your body will accumulate fat instead.

The Preoperative Visit

This visit will be scheduled approximately two weeks before your surgery. It will give you an opportunity to ask questions you might not have asked previously. We will review your medical history, give you a preoperative examination, arrange for laboratory tests, and discuss what to expect during surgery. If you are over forty years of age or have a history of heart abnormalities, we will arrange for an electrocardiogram. We will also take preoperative photographs, which become a permanent part of your medical record and remain strictly confidential. Your operative consent will be read and signed, preoperative instructions reviewed, and prescriptions given for the medications you will need after surgery. Payment of your fee will be due at this time. Facility and anesthesia fees are separate from the surgeon’s fees.

The night before your surgery be sure to take a good shower with antiseptic soap.

If your inner thighs are to be suctioned, be sure to shave your pubic hairs.

What To Expect During Surgery

Liposuction is usually performed at the Highland Park Plastic Surgery Center on an outpatient basis under a light general anesthesia. A board certified anesthetist or anestheologist will be present to make you comfortable and unaware throughout the procedure.

Before surgery begins, you will be asked to change into a surgical gown and Dr.

Toledo will talk to you as he marks the areas to be suctioned on your body. You will then be taken into a private operating room. An intravenous line will be inserted into a vein in your arm. This will make it possible for the anesthetist to administer fluids, and to deliver the necessary medications to make you comfortable. Monitoring devices will be connected to you, to assure your safety.

The area to be treated will be cleansed with an antiseptic solution, and then covered with surgical drapes. An incision approximately one quarter inch long will be made in an inconspicuous area near the area to be suctioned. A narrow, blunt ended, hollow surgical instrument will be inserted through the incision to sculpt the area by removing an appropriate amount of excess fat. After the fat has been removed, the incision will be closed with a few tiny sutures, and an elastic garment or binder will be applied to help redrape the skin and minimize swelling.

Your liposuction will take between one and two hours, depending on the amount of fat to be removed. If performed in conjunction with other procedures, surgery will naturally take longer.

What Happens After Surgery

You will be transferred to a recovery area adjacent to the surgical suite, where you will be continuously monitored as you recuperate from the surgery and anesthesia. After a recovery period of one or two hours, you will go home accompanied by a responsible adult, or transferred by our nurses for a planned overnight stay. You should feel fine, although it is not unusual to expect some minor discomfort .

You must arrange for a responsible person to spend the first night and the next day with you. We will give them instructions for your care before you leave. Have them read this paper prior to surgery. This is absolutely necessary, as you will not be able to care for yourself immediately following surgery. They will be required to wake you periodically throughout the first night.

NOTE: If you live out of town, you must make arrangements to stay within a 30 minute drive of the center for the first 24 hours after surgery.

Because everyone is different, it is impossible to write post op instructions that apply equally to everyone. For example, some patients can have sedation vs. general anesthesia or outpatient vs. inpatient surgery. Some patients have only a single procedure and others may have multiple surgeries in a single setting. Use these instructions as a general guideline, but don’t panic if we vary on some issues.

Preopertaive Guidelines

Bathe your entire body with CLn body wash the 2 nights prior to surgery and again the morning of surgery. CLn body wash is an anti-bacterial, antiseptic liquid soap. Sleep on clean sheets the night before surgery and wear clean clothes to your surgery.

Medications: Take the medications we’ve prescribed according to the instructions on the bottle. You may feel a bit drowsy, so have someone help you. If you

need a refill, call the office and give us the telephone number of your drugstore or pharmacy. Do not take aspirin or ibuprofen (Advil) for four weeks before or two weeks after your surgery. You may also refer to the medication list that will be given to you after your surgery.

Hormone replacement therapy and birth control pills increase the incidence of blood clots. STOP 2 WEEKS BEFORE AND AFTER SURGERY.

TED Hose: The Hose we instructed you to buy and wear is for the prevention of deep venous thrombosis (blood clots). Deep venous thrombosis affects mainly the veins in the lower leg and the thigh. This clot may interfere with circulation of the area, and it may break off and travel through the blood stream. This clot can then lodge in the brain, lungs, heart, or other areas, causing severe damage to that organ or even death. Any surgical procedure that will inhibit your activity post operatively there is a risk of blood clots. You will be required to wear your TED Hose during surgery and keep them on for 2 weeks after.

Smoking: Smoking or nicotine use (chewing tobacco, nicotine gum, snuff) can have a severe detrimental effect on wound healing. The nicotine decreases the vital blood supply to the skin and can cause poor healing or even skin death. STOP ALL NICOTINE PRODUCTS 2 MONTHS BEFORE AND AFTER SURGERY.

Caffeine: Excessive use of products with caffeine such as coffee, tea, or soft drinks, especially Diet Coke, can have similar effects as nicotine. STOP ALL CAFFEINE PRODUCTS 2 WEEKS BEFORE AND AFTER SURGERY.

Postoperative Guidelines

Call (214) 363-4444 if you have:

  • Severe pain which doesn’t respond to medication.
  • Significant swelling and/or unrelenting pain which occurs more on one side than the other.
  • Any other problems or questions, not answered on this instruction sheet.

Activity: You should “take it easy” the day of your operation and the following days

Increase activity slowly over the next few weeks. You are encouraged to walk around the day of surgery. Because of the medications, you may need assistance getting to and from the bathroom the first day.

Pain: The period of greatest discomfort usually lasts about 24 to 48 hours. Thereafter, you should have less discomfort and less need for medication. Occasionally, it lasts a little longer, as different people have different pain tolerances. DO NOT apply heating pads or ice to affected areas.

Bleeding: It is normal to have a small amount of blood oozing from the incision sites for the first several days.  The saline which was injected into the fat to facilitate the suction also leaks out through the suture line and will

stain your garment- DON’T WORRY THIS IS NORMAL.

Alcohol: Do not drink alcohol for five days after surgery or when taking pain medication.

Driving: You may drive when you feel up to it, starting 48 hours after surgery. Never drive under the influence of pain medication or sedatives.

Diet: Start with liquids the first few hours and then progress to your regular diet as you desire. It is important to drink fluids such as juice, water, or Gatorade in the first 48 hours.

Garment: Wear your binder/compression garment continuously for the first 48 hours after surgery. You may then remove the garment to shower once a day. A clean garment can then be alternated daily or as you desire.  You are provided one garment with your surgery, but most patients buy another garment as a backup. The garments are worn from 3 to 6 weeks, depending on the elasticity of your skin and the amount of fat removed.

Band-Aids: After surgery, band-aids are placed over most incisions around the hips, thighs, knees etc. Leave them on as long as possible, but they should be changed when they fall off or become soiled. Use heavy-duty band-aids, such as “Coverlet” brand for 3-4 weeks. The constant rubbing or friction caused by the garment can cause poor healing of the small incisions if they aren’t protected.

Bathing: You may shower two days after your surgery. Do not use very hot water.

Avoid baths or hot tubs, as your band-aids will fall off.

Sun: Do not sit in the sun at all for three weeks after surgery. You may then gradually increase sunbathing. If the incisions are exposed, apply sunscreen for six months.

Sports: Strenuous sports such as golf, tennis, swimming, jogging, aerobics, or bicycling may be resumed three weeks after surgery. Your compression garment makes exercise difficult.

Work: Depending on the kind of work you do, you may return to your job as soon as you are comfortable. If liposuction is performed on your torso or legs, and your work is fairly sedentary, you can return to work after three to five days, although you must get up to stretch and move around throughout the day. If your work involves physical activity, you may want to wait one to two weeks before resuming your job.

Postoperative visits: You will be seen in our office 3-6 days following surgery. You will be examined at this time-to make sure that you are healing well and have the normal amount of swelling and bruising. Subsequent visits: They will be determined by your progress, but usually you’ll be seen in 2-3 weeks to determine the need to wear your garment and start Endermologie.

Endermologie: This is a therapeutic massage which combines suction and rollers to smooth your skin after surgery. Endermologie not only helps smooth out irregularities from surgery but also improves cellulite. These twice a week treatments usually begin 2 or 3 weeks following surgery and last for 4-8 weeks, depending on the quality of your skin and the improvement you see. Some patients will continue Endermologie for years as maintenance.

PLEASE FEEL FREE TO CALL US AT ANY TIME DURING YOUR HEALING PERIOD. THE OUTCOME OF YOUR SURGERY IS IN YOUR HANDS AS WELL AS THE DOCTOR’S. IT IS YOUR RESPONSIBILITY TO FOLLOW ALL INSTRUCTIONS GIVEN TO YOU.

Possible Problems And Complications

No surgical procedure is without risk. Most complications associated with liposuction, however, are minor. Here are some possible problems:

Collection of blood under the skin (hematoma). This can be removed. Temporary crusting which forms on the incision.

Temporary numbness or loss of sensation in the area of the operation. This is fairly common, but in time the sensation usually returns.

Soreness, pain or itching. If these sensations occur they generally disappear with time.

Undercorrection. A revision is occasionally necessary to achieve the desired effect.

Waviness or wrinkling of the skin. If the skin is inelastic, it may not contract sufficiently after surgery.

Lumpiness or irregularities. These usually diminish with time, but may remain permanently.

Bruising and swelling. These are temporary, but may be prolonged and extensive, depending on the area treated and the amount of fat removed. Depression: With aesthetic surgery, as with other surgical procedures, this sometimes occurs postoperatively. This is generally attributed to the normal response of the body to surgery and anesthesia.

Asymmetry: No patient is identical from side to side. Small differences exist in all patients. In the occasional patient with a major difference, this may be improved with a secondary procedure.

Potential but unlikely complications

Infection.

Poor healing of skin. Loss of a small area of skin (necrosis). Overcorrection. This rarely occurs, but if it does, it will cause a permanent depression in the area of the previous bulge.

Widening or thickening of the scars. If this happens, the scars can be revised in a simple office procedure. Incisions can never be guaranteed to “heal” in a certain way.

Seroma (a collection of fluid at the surgical site). This can be removed. Complications of a severe nature which could be life threatening (e.g., leg phlebitis, fat or blood clots to the lung).

Deep venous thrombosis (blood clots) affects mainly the veins in the lower leg and the thigh. This clot may interfere with circulation of the area, and it may break off and travel through the blood stream. This clot can then lodge in the brain, lungs, heart, or other area, causing severe damage to that organ or even death. This is the reasons we have you stop hormones, wear TED hose, and walk every 3 hours the night of surgery.

Shortness of breath or labored breathing can be a sign of blood clots in your lungs.

Infection Alert

There is evidence of an increased incidence of MRSA (methicillin-resistant Staphylococcus aureus) and other antibiotic resistant bacteria in our community. In the past, these resistant bacteria were typically found only in hospitals, but they are now found everywhere. Frequently people can be a carrier of the bacteria without their knowledge. An infection with this bacteria can cause severe damage to the skin and even death. We are diligent in cleaning and sterilizing our facility and try to limit the exposure of outside bacteria from patients into our surgery center. We therefore have implemented the following hygiene steps to help prevent the contamination of our facility and therefore decrease your post operative infection risk.

Bathe your entire body with CLn body wash the 2 nights prior to surgery and again the morning of surgery. CLn body wash is an anti-bacterial, antiseptic liquid soap. Sleep on clean sheets the night before surgery and wear clean clothes to your surgery.

YOU MUST ENTER INTO YOUR SURGERY FULLY UNDERSTANDING NOT ONLY THE BENEFITS, BUT ALSO THE POSSIBLE PROBLEMS. ON RARE OCCASIONS, MINOR REVISION MAY BE NECESSARY TO ENHANCE THE FINAL RESULTS.

What You Will See In The Mirror

You will immediately see the reduction in your fatty bulges, even though it may take four to six months for all the swelling to completely disappear.

Patients with unusually large areas to be treated, or an extreme amount of fat to be removed, may need a second or even a third operation. If this is likely in your case, Dr. Toledo will let you know in advance.  Skin which is less than ideal (i.e., saggy or dimpled “cellulite”) will not be improved with liposuction, although the underlying contour can be corrected.

Your incision scar will be red at first, but will become lighter in time. Since the incision is small and is placed as inconspicuously as possible, it is generally not obtrusive.

For most of our patients, the results of liposuction are extremely satisfying.

The instructions above are general and some portions may not apply to all patients. Changes in the instructions depend on your medical history, number and type of procedures and type of anesthesia.