Body Surgery

Body contouring - Liposuction and whole body figure correction

Liposuction is the most common plastic surgery procedure all over the world. It is a permanent removal of fat cells by the use of a suction device. It is a safe procedure, with minimal down time. It has been shrouded in small controversies, and bad results, but this has been due to the procedure being done by untrained personnel, and other medicos who are not Cosmetic Surgeons.

Do not be led away by claims that the surgeon can remove 10 kgs or 12 kgs of fat and make you superthin. Please remember that the safe limits of liposuction are between 3-5% of the total body weight. Dr. Amit Gupta gives services for Lip cosmetic surgery, liposuction cosmetic surgery, liposuction surgeries, liposuction surgery, liposuction surgery india.

Procedure

The procedure involves infiltration of fluid into the areas to be liposuctioned. This has multiple benefits. It helps to loosen the fat, reduces the bleeding dramatically, and allows pain control after surgery as well. Usually Dr Amit Gupta infiltrates fluid in a ratio of less than 1:1 with the amount of fat that he plans to aspirate. The major benefit is that, what is aspirated is pure fat, and not water mixed with fat. This gives an exact estimate of the amount of fat taken out. We surgeons have a bad habit of including the amount of fluid aspirated into the total volume taken out also, so that we can boast of having done large liposuctions. What is important is not the amount taken out, but how much of actual fat there is.

The procedure is done with small incisions over selected areas of the body, after first discussing with the patient, and planning the site of the incision. These incisions generally are not visible and heal very well. They are only about ˝ cm in length. There may not be a need to admit the patient in the hospital, so that the patient can go home the same day.

Precautions

After a liposuction, there is a need to wear specially designed pressure garment for upto 6 weeks. Any anticoagulant use such as aspirin should be stopped 1 week prior to surgery; smoking should also be stopped 2 weeks before to 2 weeks after surgery for best results

Newer technology

Power liposuction, vibro-liposuction, VASER, and laser liposuction are some of the newer innovations in this field. In Power and Vibro Liposuction the mechanical effort to carry out liposuction is reduced by the use of special machines, which produce a to and fro rapid motion, thus reducing mechanical fatigue and making the procedure faster. However these are significantly more expensive than conventional liposuction. Laser lipo allows very good redraping action on the skin; however its role in actual fat reduction is a bit controversial. Thus this has not found use in general practice.

Tumescent Liposuction – how much of fluid infiltration do we really need

Most people opting for a liposuction understand the meaning of the term tumescence. Basically this means, the infiltration of fluid in the areas to be liposuctioned, so as to make it easier to perform liposuction and also allow the minimum of bleeding. This is made possible by use of various solutions and their constitution. Broadly all these solutions contain local anesthetic in the form of xylocaine, and vasoconstrictor (agents that stop bleeding). A little while back, the fluid infiltration was seen as the most major development in liposuction, but really speaking, how much of fluid do we actually need?. Lets try to answer this question as we proceed.

In tumescent anesthesia we like to infiltrate in a 1:1 ration with the expected amount of the fat to be liposuctioned. So if it is estimated that 1000 ml of fat is to be taken out, we would like to infiltrate about a 1000 ml of the solution. About half of this is absorbed by the body, and the rest is out in the aspirated fat. So in actuality when we have aspirated 1500 ml of fat after putting in 1000 ml of fluid, we can assume that the actual fat content is only about 800-900 ml. so now there is a situation where some surgeon like to infiltrate in a 2:1 ratio (called wet technique) or in a 3:1 ratio ( called superwet technique). The advantage of this infiltration is that the liposuction is virtually bloodless, it is fast, smooth. But look at the other aspect. Out of 6 litres that is aspirated in a wet technique, do not expect more than 2.5 litres of actual fat in this. So it is a good idea to ask your plastic surgeon when he tell you that he has aspirated 6 litres of fat, as to how much of fluid did he put in in the first place.

Now lets look at a reverse situation. Suppose we infiltrate about 1000 ml for about 2 litres of aspirated fat. We would assume that in an aspirate of 2.5 litres, approximately 2.1-2.2 litres is actual fat. Yes there is a little more bleeding, but never alarming enough to require blood replacement. The procedure moves smoothly, and there is prolonged pain relief due to the local anesthetic which was injected. A significant problem that occurs, when large amount of solution in injected, is the difficulty in calculating fluid replacement during surgery, and very rarely the problem of water filling in the lungs has been reported.

In a compromise situation in this scenario, it makes sense to inject in a ration of 0.5-1: 1 amount of infiltration fluid, to get satisfying results and to give the patient reasonable estimate of the amount of fat that has been aspirated.

VASER

VASER assisted lipoplasty (VAL) is a significant technological improvement over liposuction. The fatty tissue is initially emulsified using low frequency ultrasound vibrations. These vibrations are transmitted by special metal probes, which are available in different sizes according to the need of energy delivery to specific areas. The highly selective nature of VASER, is a reason for reduced complications in terms of injury to nerves, blood vessels, lymphatics and other tissues. This is the 3rd generations ultrasound assisted liposuction which unlike the previous ultrasound based treatments delivers much less intensity of power to the tissues. With VASER, it is possible to safely take out almost 7-10 litres of fat in a single sitting.

The energy which is delivered to the tissues is delivered in a pulsed manner, which decreases the overall energy amount, but increases the intensity at a particular point, this increasing the effectiveness

Dr Amit Gupta has trained with Dr Shrirang Pandit (Pandit Clinic, Pune) on VASER. Please click on VASER to read further details.

Abdominoplasty and mini abdominoplasty ( Tummy tuck and mini tuck)

Introduction

Loose hanging skin in the region of the abdomen is very resistant to any kind of exercise and is very embarrassing to the person, because it prevents wearing of proper clothes and is visible as a hanging flab of tissue. this is particularly more common in post pregnant states where the expanded abdominal skin fails to retract back to its normal contour. This tends to be less common in men.

The surgical procedure done in this condition is known as a tummy tuck or an "abdominoplasty". A tummy tuck involves removal of the excess hanging skin along with the underlying fat to give a flat and toned abdomen. This procedure tightens the abdominal muscles and gives a new, rejuvenated abdomen. The position of the umbilicus is also shifted to a more natural position.

The scar

A lot of patients are worried about the scar of the tummy tuck. It is reassuring to know that the scar can be placed according to the type of clothing that the patient prefers to wear, and it is not visible from under the clothing. Thus, if the patient wants to wear a particular type of bikini, we can site the scar accordingly. The scar can be shaped according to the type of jeans or dresses, which the patient may prefer. The scar is fine and tends to mature a lot over time.

How is tummy tuck done

Tummy tucks are done under general anesthesia. Marking for the incision and determination of the amount of tissue to be removed are done in the preoperative period. After the necessary amount of skin and fat has been removed the muscles are tightened. It is also possible to produce a shaping of the sides by tightening the muscles there.

What is mini tummy tuck

In a condition where there is not that much of lax skin and the position of the umbilicus is not too low, the surgery can be made less extensive and limited amount of skin can be removed and abdomen shaped. It is possible endoscopically to tighten the muscles of the upper abdomen to give a better shape and figure also

Post operative period

the patient needs to have restricted physical activity for about 3 weeks after surgery. Gradual walking and light exercises should be done. Sexual activity must be avoided for 3 weeks and after that care to be maintained for another 3 weeks. Child birth is to be avoided for a period of 2 years. We cousel the patient to undergo a tummy tuck once she has completed the family.

Why tummy tuck and not liposuction alone?

The loose hanging skin does not retract well, as there is damage to the elastin fibres due to stretching. liposuctioin can only remove fat, and does nothing to the skin. Thus in the event of excess skin, it is practical to consider a tummy tuck. Liposuction is combined to Shape the upper part of the tummy and give a “younger" look.

Lipoabdominoplasty

Today most of the tummy tucks are combined with liposuction in a procedure known as lipoabdominoplasty. Conventionally the lower part of the abdomen has the extra skin, which is removed. To tighten the abdominal muscles, the central part of the upper abdomen is undermined. In the lateral upper abdomen, and the flanks, liposuction is done to give a beautiful shape and leaner appearance.

Endoscopy assisted Mini tummy tuck

In a mini abdominoplasty, the upper abdomen is never undermined. However it has been seen that tightening the muscles in the lower tummy leads to a gradual bulge in the upper part of the abdomen over a few years. Therefore, some surgeons (including myself) like to tighten the muscles in the upper part of abdomen using endoscopic assistance.

Dr Amit Gupta is a Cosmetic Surgeon in Delhi gurgaon Noida. her performs procedures like hair transplant, breast reduction, breast lift, breast enlargement, silicone implants, liposuction, VASER, Botox, Filler injection, Tummy tuck, hymen repair, vaginoplasty, hymenoplasty, tumescent liposuction, face lift, rhinoplasty, bat ear correction, blepharoplasty, neck lift, midface lift, male breast surgery
Dr. Amit Gupta gives services for Lip cosmetic surgery, liposuction cosmetic surgery, liposuction surgeries, liposuction surgery, liposuction surgery india.