Body structure correction by means of liposuction
Plastic surgery devotes itself to the correction of body volumes through partial removal of adipose tissue in those areas where it is thought to be in excess. In the attempt of obtaining a more harmonious, less voluminous, more agile and pleasant body, an innovative technique has recently been introduced. The difference between this technique and the ones previously employed lies in a reduction of the amount of scars left after the operation. In fact today to reduce body volumes we make use of liposuction; that is to say, fat is aspirated by means of cannules, introduced through micro skin incisions, linked to a vacuum tank, where adipose cells are stored.
A) Adipose tissue
B) Tunnels created by the cannule
C) Fat pad thickness reduction
It is therefore possible to correct the problem with very little sign of the operation performed. The aforementioned technique has become the favorite to remove imperfections at hip, thigh, gluteus and abdomen level. Furthermore, with evolutions in the technique and the application of ever more sophisticated instruments and advanced technology, the field of pertinence has been enlarged to other more delicate areas such as knees, chin, neck and ankles. We personally deem important to perform this type of intervention by the use of very thin and delicate cannules, which allow reducing to a minimum the risk of ugly waves, grooves, adhesions and other faults that would vanish the efforts to reach the best possible body line. The adipose tissue on which we work is located between skin and skeletal muscle. When its volume increases it inevitably stretches the above lying tissues. The skin lining tends to adapt to the shape of the fat pad; being the latter mamelonated rather than smooth, skin takes on an orange peel look. Those little holes that are often attributed to cellulite, are actually nothing but the consequence of an excess of adipose tissue.
When one puts on weight, adipose cells making up a pad, increase in volume, while when one loses weight these cells tend to become smaller. Some body areas maintain a thicker fat pad in comparison with others, in spite of a well-balanced low-calorie diet and adequate exercise. In these cases we talk about localized adiposity.
It is in these areas that liposuction finds its ideal indication. In liposuction aimed at correcting localized adiposity, performed under local anesthesia, we do not normally take out more than 2000 cc of adipose tissue. Liposuction in which a volume of more than 2000 cc is removed are executed under general anesthesia. This allows better monitoring of the patient's parameters. The patient sleeps throughout the whole course of the operation and wakes up only once the dressings are completed. The kind of anesthesia to be employed is generally decided during the first consultation. The number of liposuctions under local or epidural anesthesia is ever increasing. These methods (rachianesthesia/ spinal) allow to limit to a minimum infiltration with local anesthesia and therefore the discomfort of the liquid penetrating the area to be treated. One should keep in mind that all the complications mentioned in literature are linked to the anesthetic employed rather than to the surgical technique.
Every anesthesia has its pros and cons. The advantages of local and spinal anesthesia versus general are the higher speed of drug wash out and the fact that awake patients are certainly more collaborant. Disadvantages are: for local anesthesia the discomfort of anesthetic infiltration in the region to be treated and the permanence of sensitive areas. The advantages of rachianesthesia are represented by the fact that with only one injection in the back all the areas to be treated are desensitized. Movement and sensitivity are gained back within a few hours. In rachianesthesia it is possible to develop a slight headache in the post op phase, that may last up to some days. This is due to the shot performed in the subdural space (back) that can reduce for a few days cerebrospinal fluid pressure.