Liposuction

For this type of Aesthetic surgery we are proud to have in our team Dr. Francis Otteni, MD the pioneer of Liposuction.

In 1981, Our famous plastic surgeon Dr. Otteni has published the very first articles on liposuction and lipofilling which has revolutionized the fat removal and the tissue augmentation procedures. Also as a well known name on liposuction he has later on started to improve his liposuction results by means of abdominoplasties, thightoplasties and brachioplasties. He created a new and innovative technique of Liposuction combined with Skin tightening which has improved the body sculpture surgery. Since 2001, he has been invited all over the world to teach his technique.

Liposuction by the Tumescent technique gives the safety and comfort of local anesthesia while microcannulas provide smooth precise results. It can be done with or without laser.

Facial and body sculpting by small volume tumescent liposuction is a dream come true for many of our patients at Dr. Al Rustom's Medical & Day Care Surgery Centre. Localized accumulations of fat, which are often genetically determined, are usually resistant to exercise and dieting. These can be removed permanently by liposuction surgery never to return. The following will provide you with basic information about these methods. We believe that the tumescent with basic information about these methods. We believe that the tumescent technique provides an unparalleled level of safety and precision for liposuction.

What is tumescent liposuction?

Liposuction removes excess fat from specific areas of the body to improve its shape and contours. A rigid tube that looks somewhat like a straw is inserted through tiny incisions in the skin. The tube is connected to a suction pump and by using a back and forth motion the unwanted fat is vacuumed out. The tumescent technique was developed by Dr. Jeffery Klein CXL as a way to make the procedure much safer.

Large amounts of fluid containing dilute lidocaine (for local anesthesia) and epinephrine (to greatly reduce bleeding) are gently pumped into a fatty layer through tiny needle holes in the skin until it is swollen or tumescent. The swelling of the fatty layer makes it easier to remove the unwanted fat, greatly reduces bleeding and results in numbness that lasts up to 24 hours. This numbness allows the procedure to be done without the need for general anesthesia and greatly reduces postoperative discomfort. Usually light oral sedation is used to make the injection of the fluid comfortable.

What is microcannula liposuction?

Microcannula technique is liposuction performed using very tiny cannulas (the tubes or "straws" used to extract the unwanted fat cells). This technique was developed by dermatologic cosmetic surgeons in conjunction with the tumescent technique of local anesthesia. Since liposuction is quite comfortable under tumescent local anesthesia and there is almost no bleeding, liposuction can proceed slowly and carefully.

In contrast, most plastic surgeons perform liposuction under general anesthesia or intravenous sedation anesthesia. This requires working rapidly because of the risks of anesthesia. In addition, bleeding can be significant without careful and complete tumescent infiltration. So they most often use larger cannulas, typically 4 to 5 millimeters or larger (about the size of your little finger).

By using very tiny microcannulas – typically about the size of a thermometer – there are several advantages: First, the liposuction can be performed through very tiny needle access holes. These heal quickly, and are essentially invisible when healed. The microcannulas make for a more gentle procedure and produces the most smooth and even result possible. With microcannulas, it is easier to control the progress of the procedure and minimize the risk of taking too much fat out of an area. This reduces the chance of ripples, irregularities or uneven results. In addition, the tiny channels from microcannulas contract very well allowing the skin to contract and drape well after the procedure.

Will liposuction work for me?

Liposuction works best for people who have localized areas of fat that do not respond to diet and exercise. You need to be in good health and reasonable expectations. Liposuction is not a substitute for weight loss but there is no definite age limit or weight limit for liposuction. It is important to have realistic expectations about what liposuction will do for you. It works best to improve your shape: it changes your "inches" but does not change your "pounds". For example, removing an amount of fat equivalent to a half-pound of butter from each outer thigh of a woman’s saddlebag areas, or from a man’s love handles, will result in a dramatic improvement in appearance of these areas but it does not significantly change the person’s weight.

Dimples, ripples, and cellulite may remain unchanged or be only moderately improved with liposuction. Liposuction sculpts bulging areas into more attractive contours. During your consultation visit before surgery, Dr. Al Rustom will discuss the procedure with you and relate what you can realistically expect. Possible complications, risks, alternative treatments as well as the benefits will be fully discussed. Before and after photographs are usually taken to help evaluate the amount of improvement.

Facts about fat

Body fat on an adult tends to increase gradually over the years. After 30 years of age an individual tends to add fat according to a genetically predetermined pattern. This fat pattern is often resistant to change by diet and exercise. Examples of this are the pouches of fat beside the chin called jowls, the "love handles" above the hips on men, and the "saddle bag" accumulations of fat on some women’s upper thighs. For many people, liposuction is the only realistic means of changing the body’s silhouette. In effect, liposuction is the equivalent of being able to focus the effects of dieting to specific areas of the body.

Which areas can be treated?

At Dr. Al Rustom's Medical & Day Care Surgery Centre we most often treat fat accumulations in the lower face (including the jowls, cheeks, and chin areas) and the neck. The most frequent body areas treated in women include: stomach, thighs, hips, "saddle bags", buttocks, neck, and the knees. For men: it is most often the "love handles", abdomen, breasts and the neck and chin.

Before		After

Does the fat stay away permanently?

Yes it does. Fat cells removed by liposuction do not grow back. You have all the fat cells you are going to make in your life by the end of puberty. When you gain weight, you expand fat cells that you already have. Tumescent liposuction permanently removes fat cells. If you gain weight after liposuction, it will go to the fat cells remaining in your body in areas where you have not had liposuction rather than ballooning out those old troublesome areas.

Usually one procedure is all that is needed for a treatment area. A few patients may benefit from a fine-tuning liposuction procedure 6 months to 1 year later. Virtually no blood loss and no need for transfusions

As a result of the blood vessel constriction from the epinephrine in the anesthetic solution, there is very minimal bleeding during and after surgery. There is no need for blood transfusions.

The greatest dangers of traditional liposuction surgeries have been shown to be related to 3 factors: The risks associated with general anesthesia and/or deep IV sedation. The risks associated with blood loss and fluid replacement. The risks associated with excessive liposuction (megaliposuction). These major risks are reduced or eliminated by adhering to the tumescent technique.

The drugs used for general anesthesia are relatively more dangerous than those used for local anesthesia. The risks associated with these medicines including respiratory arrest and allergic reactions to them are eliminated by not using them. Local anesthesia is considerably safer. And tumescent liposuction provides better comfort. (Usually only plain Tylenol is needed during healing.)

The risks associated with substantial blood loss during traditional liposuction are eliminated by using the tumescent technique. The amount of fat removed in any one surgery needs to be strictly limited for safety’s sake. At Dr. Al Rustom's Medical & Day Care Surgery Centre we limit the fat removed to moderate amounts and adhere to the guidelines for tumescent liposuction established by the American Society for Dermatologic Surgery. Safety is our first priority.

How is the skin affected?

Because the microcannulas are so small, they make very tiny tunnels through the fat. This leaves many normal fibrous connections between the skin and the underlying tissue. These fibrous connections retract during healing and maintain the skin in its natural position. After liposuction with the tumescent technique one does not have to worry about the excessive folds of skin in the area. Many patients who would have to have a tummy tuck with previous methods, can now have very good results simply through liposuction. This is also true in the neck area, as long as pre-existing skin laxity is not excessive.

Liposuction is not appropriate for everyone. You will receive full information about tumescent liposuction, including possible risks and limitations, and how it might help you, at your consultation before scheduling any treatment.

We apologize for not showing photos of the body for ethical reasons. You may refer to the following website for before and after photos: www.plasticsurgery.org

• Important Information about Tumescent Liposuction
• Before Liposuction Instructions
• What to Expect on the Day of Tumescent Liposuction
• After Liposuction Instructions