Liposuction

Liposuction is a highly successful technique to remove localized fatty deposits that are resistant to diet and exercise, or that are hereditary. It is not a means to overall weight loss.

In Dr. Chartchai's experience, liposuction is an excellent technique to help sculpture the body by removing the unwanted fat deposits. Dr. Chartchai's clients who request liposuction in Bangkok include men and women who are physically fit and shapely but who have localized areas of fat that simply won't go away despite months and sometimes years of regular exercise, and others for whom liposuction is a necessary adjunct to a procedure such as an abdominoplasty in order to achieve the best results of the plastic surgery.

Subcutaneous fatty tissue, which exists above muscles and under the skin, is a well defined layer that creates softness and hides the angularity of the bones of the body. When excess fatty tissue is deposited in certain areas, a person looks overweight.

Unwanted fat cells are removed with their accumulated fat, leaving behind connective tissue, the blood vessels, and the nerves. The space left after the fat cells are removed is obliterated with small amounts of scar tissue. With liposuction the cells and fat that are removed will not regenerate. Liposuction causes a permanent change in the shape of the body.

What do you want to change?
The usual goal for liposuction is improvement, not perfection. Having realistic expectations can make the entire experience much more satisfying and reduces the chance of disappointment. If at the start of the process you have tight, hard skin, then you will probably end up the same way, but with better contours. If your skin surface is wavy, dimpled or wrinkled to start with (indications of cellulite), the contours of your body will improve, but the surface may retain the same wavy, dimpled appearance.

The ideal candidate is a healthy person with good skin tone who is within 30% of his or her ideal weight. Liposuction is not recommended for people with diabetes, heart or lung conditions, a history of blood clots, anemia or poor skin tone.

Liposuction is useful for the following areas: lower abdomen, calves and knees, inner and outer thighs, hips and flanks, buttocks, love handles, back and chest, upper arms, neck and jowls. Liposuction can get rid of stubborn fatty deposits, especially in the upper arms and love handles, where usually no amount of dieting, sit ups or push ups will help.

Cellulite responds poorly to liposuction. Cellulite is deposits of subcutaneous fat separated by fibrous septa that creates a dimpling or bulging effect on the overlying skin. Sometimes when this fat is removed the dimpling can become more prominent. Current VASER [Ultra sound assisted liposuction] seems to help shrink the cellulited skin.

A beer belly cannot be reduced by liposuction. This fat is not subcutaneous fat. It is found under the muscle within the abdomen itself. It is sometimes called mesenteric fat. It not accessible by liposuction and can only be lost by diet and exercise.

Procedure
The procedure, using local or general anesthesia, can take anywhere from 30 minutes to a few hours, depending on how much fat is removed, how difficult the fat is to reach, and how many areas are being treated at one time.

Dr. Chartchai now performs tumescent coupled with VASER lipolysis which is a kind of ultrasound assisted liposuction [UAL], whereby large volumes of saline solution mixed with local anesthetic and adrenaline are injected into the fat to make cells easier to remove. A small hole is made so as to be later hidden in a crease of the body. A VASER probe will be passed through the fatty layer to melt the fat cells which will be suctioned out with a small canula through a low pressure suction system. The VASER lipolysis is aimed to tone and tighten the skin compared to conventional liposuction alone.

The Acculift liposcupture system which is a laser assisted liposuction [LAL] is also in use especially for the facial area

The amount of fat removed varies. If the body build is average but the patient has excessive fatty deposits, the maximum amount of fat to be safely removed at one operation is 4 liters.

Liposuction never removes all the fat cells in any area. Some fat cells are always left behind and are necessary to provide normal contours.

Recovery time
Post surgery there will be swelling, bruising and a burning sensation in some areas. A compression garment must be worn for 4-6 weeks after the surgery to control swelling and to shape the skin to its new contour. After 6 months, the swelling will subside.

You may return to work depending on the amount and size of the area that has received liposuction.

There will be some swelling and bruising, and possible numbness or a burning sensation at the treated areas. After liposuction, the skin needs to shrink to its new contour and this takes time. A compression garment should be worn for 2-4 weeks to control swelling and shape the skin. Within 6 months the swelling will have subsided.

Strenuous exercise may be resumed after a month or more - Dr. Chartchai will advise you what is best for you.

Older patients whose skin is no longer lax, or women whose abdominal skin is badly stretched, may need to have the resulting excess skin removed as it will not shrink back to tightness.

Time off work is highly dependent on how large of an area is liposuctioned. If a single area is liposuctioned then it may be possible to return to work the next day after surgery. As more areas are liposuctioned the amount of bruising and swelling increases and the recovery time increases.

Possible complications
Bleeding and infection may occur. Some common risks are uneven contour, dimpling and skin surface irregularities. Other complications include nerve damage, excessive fluid retention, blood clots and perforation of organs. A fat embolism is a rare but possible complication found in large volume liposuction.