THE DERMATOLOGY
COSMETIC CLINIC
and
SOUTHERN LIPOSUCTION CLINIC

Liposuction and Liposculpture

Liposculpture is carried out using the technique of Tumescent liposuction, invented and developed in 1985 by American Dermatologist & Pharmacologist Dr Jeffrey Klein.

The word “tumescent” means swollen and firm. By injecting very dilute anaesthetic and epinephrine (a small blood vessel constrictor) into subcutaneous fat, the targeted tissue can be made tumescent. The tumescent technique provides local anaesthesia of subcutaneous fat and thus permits the entire liposuction procedure to be performed under local anaesthetic. Tumescent anaesthesia eliminates both the need for general anaesthesia and the need for IV narcotics(intravenous pain killers) and sedatives.

Because tumescent local anaesthesia lasts a long time, tumescent liposuction is less painful than liposuction under general anaesthesia or IV sedation. With tumescent local anaesthesia there is usually no post-operative nausea or vomiting that are frequently associated with general anaesthesia.

Tumescent vasoconstriction (the constriction of blood vessels) is so good that the liposuction can be performed with virtually no blood loss. This is in contrast to the older forms of liposuction which were often associated with significant surgical blood loss.

Dr Bellaney is a New Zealand Dermatologist who has been a practicing Cosmetic Dermatology since 1996. He has been performing micro-liposuction since 2000 and has received training in tumescent liposuction in both Australia and the United States and Europe. He set up the South Island's first specialist Tumescent Liposuction clinic in Christchurch in 2004. He is one of New Zealand's most experienced Tumescent Liposuction practitioners.

Microcannulas
A liposuction cannula is a stainless steel tube which is inserted into the fat via small “adits” or incisions in the skin. The microcannulas Dr Bellaney uses have an outside diameter of 3 millimeters or less. Microcannulas replace the need for large cannulas, which in the past often left visible scars.

A more even skin appearance can be achieved by using microcannulas which allow a much more precise and controlled removal of fat. This improves the ability of the surgeon to achieve smoother results. Large cannulas are associated with an increased risk of liposuction producing skin depressions and irregularlities. Large cannulas may remove fat so quickly that there is a risk of removing too much fat.

Adits
Adits are small superficial holes made in the skin. Adits allow the liposuction cannula to be passed in and out during the liposuction process. Adits also allow drainage of any blood-tinged anaesthetic solution after liposuction. Because of the skins ability to stretch the cannulas usually fit through a 1.0mm, to 2mm round hole made in the skin. These holes usually disappear without scars after liposuction. Adits are so small that it is not necessary to close them with stitches. Because Adits are not closed they promote post-operative drainage of the tumescent fluid. This reduces post-operative bruising, tenderness and swelling compared to other forms of liposuction that require larger incisions.

Important Information about Tumescent Liposuction

Risks of Liposuction Surgery:
Any surgery involves the risk of infection, bleeding, scarring or serious injury, however tumescent liposuction has an outstanding safety record. Tumescent liposuction is so safe because neither general anesthesia nor significant IV sedation is required. A recent survey involving over 15,000 patients who had tumescent liposuction without general anesthesia revealed the following: No serious complications, no serious infection, no hospitalizations, no blood transfusions, and no deaths.

The greatest risks of liposuction are those associated with general anesthesia. By eliminating general anesthesia, the risks of liposuction are dramatically reduced.

Skin texture before and after Liposuction:
Tumescent liposuction using microcannulas is the least likely form of liposuction to cause any significant or noticeable post-surgical irregularities of the skin. By magnifying the fatty compartment, the tumescent technique permits more accurate removal of fat, with greater assurance that the liposuction cannula will not inadvertently approach too near the undesurface of the skin and thereby cause skin irregularities. Thus the tumescent technique helps to minimize the risk of post-surgical irregularities or rippling of the skin.

It is unrealistic to expect perfectly smooth skin. Patients should expect that their skin will have approximately the same degree of dimpling and irregularities as existed before tumescent liposuction surgery. After tumescent liposuction the skin texture should be within normal limits. A casual observer should not notice any evidence of surgical irregularities of the skin

However, it is possible that a noticeable irregularity of skin may result. If an irregularity occurs, it may require a corrective procedure. Because skin tends to lose some of its elasticity with increasing age and with cumulative sun exposure, older patients might notice some subtle increase fine wrinkles in areas such as the upper abdomen after liposuction.

Cellulite:
Liposuction of the thighs, while improving the silhouette, does not necessarily eliminate the subtle puckering of the skin often termed cellulite. Cellulite results from the pull of fibrous tissue that connects skin to underlying muscle. While tumescent liposuction may reduce the degree of cellulite, it is unlikely to eliminate it. Liposuction should not worsen cellulite.

Obesity & Liposuction:
Liposuction is not a substitute for a prudent diet, good nutrition, and regular exercise. Obese patients may be good candidates for limited liposuction if their goal is simply to improve the shape of certain limited areas of the body. Obesity is associated with an increased risk of surgical complications.

Risk of Scarring of the Skin:
Incisions for liposuction may result in scarring. Tiny (1 to 2 mm) round holes in the skin, called adits, are used for inserting the cannulas through the skin and into the fat. Typically, when adits heal they become virtually invisible. Although you may be able to find them upon close examination, most other people would not be able to see them. Some patients may experience temporary hyper-pigmentation (darkening) that usually fades after several months. Some patients may have a genetic predisposition for persistent discoloration at incision sites. Any one who has previously experienced hyper-pigmentation or hypo-pigmentation (pale or light coloured scars) of the skin in the past might expect to also experience it with liposuction adits or incisions. Certain areas of the body, such as the back or upper flanks, may be more likely to have pigmentation changes.

Postoperative Healing:
Normal healing after tumescent liposuction involves a limited but definite degree of soreness, swelling, bruising, itching and lumpy firmness. Rarely a temporary mild numbness, itching or burning of the skin may persist for 2 to 10 months. Most patients can actually see some improvement of their silhouette within one week after surgery. However, because of the slow resolution of post-surgical swelling, the ultimate results following liposuction usually require 12 to 20 weeks to be achieved.

Realistic Expectations:
Although the results of liposuction are often quite spectacular, it is not realistic to expect perfection. It is impossible to guarantee the precise amount of improvement that will result from liposuction. Patients should not have unrealistic expectations. Although patients can usually expect to achieve at least a 50% improvement, it is unreasonable to expect 95% improvement or near perfection. For the perfectionist, or for liposuction of a very large area, maximum improvement may require a second procedure.

Longevity of Results:
The fat cells that are removed by liposuction do not grow back. If the patient later gains or loses weight, the change tends to be distributed proportionately over the entire body. Although one can expect some changes with ageing, provided that the patient’s does not gain large amounts of weight, the patients new, pleasing silhouette is relatively permanent.

For additional and more detailed information about the safety of tumescent liposuction go to www.liposuction.com.