Fat removal surgery is one of the most common cosmetic procedures, the popularity of which is growing every year. Modern methods have been improved so much that they can remove more than 10 liters of adipose tissue, and minimally invasive technologies reduce the risk of complications to a minimum.
How did liposuction come about?
A slender, fit figure is the ideal of beauty in modern society. The first operation to remove fat was carried out back in 1921 in France. And although it ended unsuccessfully, it marked the beginning of a new direction in the beauty industry.
Following attempts resumed only in the 60s of the XX century. It is impossible to call the technology of that time safe and effective - fat was removed using a curette, scraping through small incisions in the skin. This was accompanied by a large number of complications, the development of inflammatory processes, the formation of rough scars. The tissue healing time was also very long.
In 1974, one of the Italian gynecologists suggested using a hollow tube instead of a traditional curette, insidewhich rotated sharp knives. Three years later, a new type of instruments entered surgical practice, thanks to which vacuum suction of fat was performed. This technique has been widely adopted and formed the basis of modern technology.
In the 80s. 20th century Swiss doctors came up with the idea of impregnating adipose tissue with hyaluronidase in a saline solution. The addition of the hormone adrenaline, which constricts blood vessels, also significantly reduced the number of complications.
In medicine, there is a certain term for the name of the operation to remove fat - liposuction. This definition was coined by the president of the American Society of Plastic Surgeons.
In 1985, a modern composition of tumescent liquid was developed (a mixture of saline, anesthetic and adrenaline). Injections of fluid into the adipose tissue made it possible to perform this operation almost painlessly, with the least blood loss and complications.
Indications
Indications for plastic surgery to remove fat are as follows:
- Removal of local fat deposits localized on the abdomen in front and sides, on the inner and outer thighs, under the chin, in the middle and lower back, in the knees and shoulders.
- Complex adjustment of proportions during abdominoplasty (restoration of the proportions of the abdomen), rhytidectomy (surgical facelift), mammoplasty (reduction of the mammary glands) and other surgicalinterventions.
- Elimination of benign formations. Most often, this technology is used for large lipomas.
- False gynecomastia in men - an increase in the mammary glands due to the redistribution of adipose tissue.
- Elimination of hyperhidrosis (excessive sweating) in the armpits.
What can't be fixed with liposuction
Contrary to popular belief among patients, fat removal surgery is not for patients who experience:
- Obesity. Excess body weight is corrected using other methods - dieting, taking special medications, psychotherapeutic and surgical treatment (gastric bypass and banding, sleeve gastroplasty). Moreover, liposuction shows the greatest effectiveness in people with a body weight close to normal. Such an operation is aesthetic in nature and is intended to correct uneven fat deposits, and not to normalize lipid metabolism.
- Cellulite, as it is a degenerative change in the superficial layers of fatty tissue, and liposuction is carried out more deeply.
- Stretch marks (stretch marks). This operation cannot correct the decrease in skin elasticity and increase its firmness.
Contraindications
Contraindications for fat removal by liposuction are:
- pathology of the circulatory system, poor blood clotting;
- severe diseases of internal organs and systems;
- endocrine obesity (pituitary type orcaused by pathologies of the thyroid gland);
- very low firmness and elasticity of the skin (since removing fat will cause it to sag and wrinkle);
- endocrine disorders (severe diabetes mellitus, uncompensated hypothyroidism and others);
- individual intolerance to drugs used during the procedure;
- heart, kidney, liver failure;
- inflammatory and purulent processes in the area of surgical intervention;
- chronic infectious diseases;
- pregnancy;
- any disease in the acute phase;
- immunodeficiency states;
- oncological pathologies.
Liposuction is not performed on women during their period. It is necessary to wait 5-7 days after they end.
Before performing fat removal surgery, the doctor should take a history and assess the risk of complications due to the presence of any diseases. If it is large, then the operation must be refrained from.
Types of liposuction
There are the following types of liposuction:
- Standard (traditional): dry and wet. Its advantages are simplicity and relative cheapness, while its disadvantages include tissue trauma and a significant number of side effects. Large blood loss sometimes requires a blood transfusion.
- Tumescent. Such an operation is characterized by less blood loss, local and general complications, and a good aesthetic effect. Perone procedure can remove up to 4-6 liters of fat.
- Ultrasonic. The disadvantages include the high cost of equipment, and, consequently, the price of the procedure. Depending on the operating area, the efficiency can be either medium or high.
- Laser. Shows good results in patients with reduced skin elasticity.
The last three types are non-invasive liposuction techniques. The choice of method depends on the localization of fatty deposits, the planned volume of the surgical operation, the availability of the necessary equipment and instruments.
Traditional liposuction
Dry aspiration fat removal, put into practice in 1974, is the most traumatic. Currently, cannulas of different diameters are used, and aspiration (suction) is performed in a gentle mode. This procedure is performed only on limited areas of the body and under general anesthesia.
More perfect wet liposuction is different in that the surgical area is pre-chip with solutions. In both cases, there is a limit on the maximum amount of fatty tissue removed during this procedure - no more than 1 liter.
Tumescent liposuction
The operation to remove fat in this case is similar to traditional wet liposuction. However, the tumescent solution, also called Klein's solution, has a special formulation. There are also its modifications, for example, sodium bicarbonate is introduced, which contributes to moreeffective penetration of fluid into tissues. The main composition described above remains constant.
The volume of the tumescent solution is selected depending on the area of surgical intervention. Its ratio with fatty tissue fluctuates in the range of 1:1-1:3. Aspiration begins after 20-30 minutes. The operation is also performed under general anesthesia.
Preparation
Preparation for liposuction, as for any planned surgical intervention, is the following tests and examinations:
- blood test (general, biochemical, clotting, HIV, syphilis, hepatitis C and B, determination of group and Rh factor);
- urinalysis;
- consultation of a mammologist and ultrasound of the mammary glands, if the operation is performed on the breast;
- ECG;
- examination by a gynecologist (women only);
- chest X-ray.
After passing the tests and studying the anamnesis, the therapist makes a conclusion about the state of he alth. The patient is also examined by an anesthesiologist, who finds out if there are allergic reactions to medications, what diseases and operations have been previously transferred, whether there are bad habits (as they can affect anesthesia). Compression garments may be required after surgery and must be purchased in advance.
At least 1 week before the procedure, the patient should stop taking drugs that affect blood clotting. These include tools such asacetylsalicylic acid, polyunsaturated fatty acids, vitamins A, C, E; iron preparations. They can also not be drunk during the recovery period. On the eve of the operation, it is necessary to take a shower, and refuse to eat and drink 6-8 hours in advance.
Performing a standard liposuction procedure
Liposuction according to traditional and tumescent methods is performed in stationary conditions. First, the doctor marks the problem areas on the patient's body (marking the surgical field) and the direction of movement of the probe.
In the wet method of surgery to remove subcutaneous fat, painkillers are injected into the area, and then Klein's solution is injected to liquefy and facilitate the removal of adipose tissue.
Then the surgeon makes small incisions 1-2 cm in size and inserts the cannula. It is a metal hollow tube. By moving the cannula, the doctor destroys adipose tissue, which is then removed using vacuum suction.
The duration of the procedure depends on its volume - from 30 minutes to 2.5 hours. On average, the operation to remove fat from the abdomen lasts 1.5 hours.
Rehabilitation period
The length of stay in the clinic depends on the general condition of the patient and the type of anesthesia - if it was local (with a small removal), then the discharge can be made after 2 hours. If general anesthesia was used, then on average - after 1 day. This is due to the fact that detoxification therapy, elimination of water and electrolyte disorders, preventioninfectious complications and other therapeutic measures.
One of the most important conditions for the prevention of complications is the wearing of compression underwear. Its use is indicated around the clock for 1-4 weeks. This is necessary so that the skin does not sag and to eliminate edema. A diet low in s alt is recommended during the recovery period. You should refrain from sports, sunbathing and baths.
In the first 2-3 days, there may be a feeling of pain and burning, and in the area where the fat has been removed, bumps and seals are observed. The final result becomes visible after a few weeks. After 14-20 days, the skin will begin to tighten, and the contours of the figure will smooth out. Restoration of normal activity occurs within 1-4 days. Physical activity is acceptable after 1-2 months.
Side effects and complications
Liposuction surgery is characterized by the following side effects and complications:
- The appearance of hematomas, internal bleeding. Bruises form in almost all patients and eventually go away on their own.
- Edema.
- Pain syndrome (especially with traditional liposuction).
- Disturbance of blood flow through the vessels caused by the introduction of anesthetics during tumescent liposuction.
- Formation of scars and scars, "bumpiness" of the skin.
- Development of infectious inflammation.
- Numbness (loss of sensation). In severe cases, rehabilitation therapy may be required. Sometimes the numbness becomes irreversible.
- Skin necrosis in the aspiration area. Most often, this complication occurs in elderly patients and in those who have chronic diseases or reduced immunity.
- When performing ultrasonic liposuction, in rare cases, the probe may break, damage internal organs, thermal burns, and the formation of accumulations of serous fluid.
The risk factors for these negative phenomena are bad habits, early start of physical activity and refusal to wear compression stockings.
Ultrasonic liposuction: features and technique
The difference between non-invasive liposuction using ultrasound is that after the introduction of a tumescent solution, fatty tissues are destroyed by ultrasonic waves. The radiating tip is constantly moved in a reciprocating direction, since prolonged exposure to the same area can cause thermal damage. In one position, the tip should be no more than 2-3 s. Modern equipment allows the replacement of the probe and removal of fat at the same time, during one operation.
The basis of this technique is the phenomenon of cavitation. The gases dissolved in the intercellular tissue under the influence of mechanical vibrations created by ultrasound merge and turn into microbubbles that collapse sharply. As a result, fatty tissue is destroyed, becomes softer and is easily removed through thin tubes connected to an aspirator.
During the procedure, the surgeon evaluates the thickness of the fat fold by lifting the cannula orwith a pinch, pinching the skin between the fingers. At the end of liposuction, he puts stitches and sterile wipes on the wounds. Then the patient is put on a compression garment, under which foam or silicone plates can be placed to obtain a greater leveling effect.
Laser lipolysis
Another technology for removing fat without surgery is laser lipolysis, the destruction of fat cells with a laser. Due to its high precision, this method can be used to affect small areas of the body, in particular, on the face. The laser beam also stimulates collagen production, which improves skin elasticity.
The technique for performing laser lipolysis is as follows: heads with an emitter are placed on the skin, which are fixed with straps. Then turn on the equipment for 10 minutes. Passing through the surface layers, the laser beam hits the fat cells and opens their pores. Fatty acids, water and glycerol from the cells go into the intercellular space, and then are excreted by the lymphatic system into the venous bed.
One course of treatment consists of 5-15 sessions, which are carried out every day or every other day. To increase efficiency, this procedure is combined with laser-vacuum massage. The decrease in the thickness of the fat layer ranges from 1-8 cm. The duration of one procedure is 0.5-1 hours.
The benefits of this exposure include the following:
- quick recovery, no need for hospitalization;
- good tolerability, fewer side effects (bleeding,hematomas, irregularities);
- no postoperative sutures.
Prices
There are several factors that affect how much fat removal surgery costs:
- applied technology;
- type of anesthesia;
- volume and zone of surgical intervention (if the total volume of fat removed is more than 10 liters, then the price for the operation of one zone can reach 160 thousand rubles);
- level of the medical center and its location;
- number of preliminary examinations and analyzes, consultations with specialized doctors (total costs may vary between 8-20 thousand rubles);
- length of stay in hospital (one day costs 3-6 thousand rubles);
- the need to wear a bandage (4-12 thousand rubles).
Therefore, the cost of this procedure is individual for each patient. Those prices that are listed on the websites of cosmetology clinics are only indicative and, as a rule, are indicated only for the operation itself. The average cost of liposuction in Moscow clinics is as follows (in thousands of rubles):
- hip area – 60-80;
- buttocks and lumbar region – 80;
- belly (only upper or lower part) - 45-50;
- whole belly - 80-90;
- chin, cheeks, knees - 20-30.
Some clinics indicate the price for liposuction of one zone, the area of which is 10 cm2. On average, it is 30 thousand rubles.
