Liposuction & Fat Transfer

Genetics and diet are the main determining factors for body fat distribution.  Heredity determines the number and location of individual fat cells, which do not change after puberty. The amount of fat in each cell is controlled by the diet, which does not affect the total number of cells.  For example, if you have inherited large numbers of fat cells on your abdomen and small numbers of fat cells on your thighs, you will always have more fat on the abdomen than on the thighs, and strenuous attempts loose weight can leave you with a thin thighs and persistently large abdomen.

Tumescent Liposuction is a surgical procedure for removing localized deposits of subcutaneous fat anywhere in the body. This technique uses minute incisions and a high vacuum to remove fat cells in selected areas, thereby changing contour of the treated areas.  Tumescent liposuction technique was invented by a dermatologic surgeon and represents one of the most significant contributions to the field of cosmetic surgery. The tumescent technique is the safest form of liposuction and reduces risks of bruising, pain, and downtime compared to liposuction under general anesthesia.

Your appearance after liposuction will be mainly influenced by your age, weight, the overall condition of your skin, and general state of health. Each patient is unique, and during your consultation Dr. Khrom will outline how these general factors apply to you in particular.  You should have realistic expectations, as liposuction does not substitute healthy diet and exercise, and is not particularly useful for generalized weight reduction.

Liposuction selectively removes fat only from those areas in which the patient desires reduction.  Your new figure will be similar to what you would expect if you could lose an equal amount of localized fat through diet and exercise alone.  The procedure is permanent, and following liposuction the body will irreversibly have less fat in the treated areas. A consultation appointment with Dr. Khrom is important to discuss your best options and to set realistic goals for your final results.

Overall condition of your skin: Good skin elasticity is desirable, since it makes for a smooth surface contour. Tight skin is universally seen in the very young and is gradually lost with aging. Some degree of skin elasticity is retained even at middle age. This unique skin property allows for tight contouring following appropriate liposuction.

Cellulite: The word “cellulite” has no precise medical meaning. People loosely use the word to describe irregularities and dimpling on the surface of the skin. It is most frequently located over the lower torso and thighs, worsens with age, and is often associated with loose skin (see below).

While liposuction is not a cure for cellulite, it will remove fat and reduce contour. In mild cases liposuction may decrease the intensity of cellulite. Severe cases, however, require abdominoplasty ("tummy tuck") or thigh lift for permanent improvement.

Loose Skin and Musculature: Some individuals exhibit muscular and skin laxity, with or without excess fat. These patients require additional procedures such as abdominoplasty (tummy tuck) or thigh lifts. During your consultation Dr. Khrom will evaluate your skin and musculature as well as localized fat deposition. If you require thigh lift or abdominoplasty for optimal results, Dr. Khrom will so inform you.

Procedure

Depending on how many areas are treated the liposuction lasts 30 minutes to 2 hours. Because the procedure is performed completely under local anesthesia, the patient is awake and is able to provide feedback on the results during liposuction.  The patient input is invaluable to ensure that patient’s expectations are met with regard to symmetry, shape, and extent of sculpting.

Most likely one procedure will be sufficient. A very small percentage of patients require a fine tuning procedure at 6 to 12 months after the initial procedure. Dr. Khrom’s technique with local anesthesia combined with proper positioning that takes into account the effect of gravity significantly reduces the chances of a touch-up procedure.

After Surgery you will be placed in a support garment, which may temporarily be removed just for a shower starting 24 hours after liposuction.  You are expected to wear the elastic support garment over the treated area to aid healing for the first week at minimum. Following the procedure you will go home and rest for a few hours, after which you may gradually increase your activity as tolerated. Activity is encouraged and is believed to facilitate healing.  With the local anesthesia technique, you may be able to resume normal activities within 24-48 hours.
Following liposuction minor discomfort is expected for which you can take Extra Strength Tylenol.  In the rare event that your pain is more significant, stronger analgesics will be called in to your pharmacy.  There is usually only mild discomfort thereafter. All patients typically return to work in three days.

Photographs: Preoperative photographs will be taken. The body photographs do not show your face. They are important aids in planning and performing liposuction and become a permanent part of your medical record. Postoperative photographs are taken 6 months after procedure.

Scars: In the past, scars from body contouring were long and conspicuous. Tumescent Liposuction techniques have changed that.   The minute incisions are now placed in natural body creases or in other areas where they are inconspicuous or easily hidden by clothing or bathing suits. In most patients the scars are not noticeable by 12 months after the liposuction.

Complications and Untoward Results: Serious complications are uncommon with this kind of procedure. All patients have bruising, which may last 3 to 6 weeks, occasionally longer. A temporary numbness or reduced sensation in the treated area is also expected, mostly due to lidocaine anesthetic. As with any minor surgery, bleeding, infection, and allergic reactions are possible.

Fat transfer, also called autologous fat transplantation or micro-lipoinjection, plumps up facial features with a patient's own fat and is a popular alternative to other wrinkle treatments. Fat transfer to the face is a safe, natural, non-allergenic procedure designed to recontour your face and can provide definition to your cheeks and chin. It can also be used to correct facial deformities. Since fat transfer uses your own fat cells, you can never have an allergic reaction, because it's from your own body.

With fat transfer it is possible to have fat liposuctioned from your thighs and then transferred to any area of your body. Reinjected fat lasts longer in larger areas of non-movement, so it is very successful for the correction of sunken cheeks because this area does NOT move as often. Fat transfer can also correct atrophic aging of the hands, post-surgical and post-traumatic defects.

It is also used to correct facial deformities. With this type of natural filler you can never have an allergic reaction, since the fat transferred is from your own body.

It is possible to have excess fat liposuctioned from one body area and then transferred to any other. Re-injected fat lasts longer in larger areas of non-movement, so it is very successful for the correction of sunken cheeks because this area does not move as often. Fat transfer can also correct post-surgical and post-traumatic defects. Not every area of the body responds to fat transfer equally well.  Dr. Khrom believes that fat transferred to the face can last as long as three years.  Fat transfer can be very cost effective, especially when combined with another procedure.

The downsides are the fact that fat has to be harvested from another area and the are of injection is frequently swollen and bruised for several weeks.  Results vary.