Vistnes Plastic Surgery of Palo Alto, Dean Vistnes 1515 El Camino Real, Suite B, Palo Alto, CA 94306

Palo Alto Liposuction FAQs

How Does It Work?

How exactly does UAL work to remove and sculpt the fat we tend to accumulate? UAL uses sound waves (ultrasound) to liquify unwanted fat deposits. The ultrasound energy waves are produced using a small ultrasound generator and hand piece, then transmitted down to the tip of a specialized titanium cannula. This energy causes the tip of the cannula to vibrate rapidly back and forth over 22,000 times per second.

Imagine a fat cell as a water balloon – inside the balloon (fat cell) is the stored fat. When the tip of the cannula comes in contact with a fat cell, it creates a process called “cavitation”. Cavitation causes the fat cells to rupture, releasing the liquid fat stored inside the cells. This liquid fat becomes emulsified or mixed with a saline solution that is injected into the fat before the ultrasonic energy is applied. As the fat is released and emulsified, it is gently suctioned out through the same cannula under low, gentle pressure. It is a less traumatic way of removing the fat, and one that allows more control in actually sculpting the treated areas. Just like a water balloon with a tear in it, the fat cells are no longer able to store fat once they have ruptured. If weight is gained back in the future, it will tend to be stored in other areas with intact fat cells.

Because we are no longer relying on high-powered suction pumps to vacuum out the fat, there is less trauma to the body with UAL. Smooth, slow, and gentle motions are used with UAL, leaving blood vessels and nerves intact, so there is significantly less bleeding and post-operative pain. Remember – UAL does NOT use heat to liquify and remove fat – it uses sound waves. Because it is considerably gentler on your body, not only can you obtain excellent contouring, but the recovery is faster.

What Should I Expect?

Immediately prior to surgery, patients are marked in the standing, upright position to precisely define the areas that are to be treated. A “contour map” is drawn on the skin overlying the fat bulges, and then “feathered” around the edges to allow a smooth, even transition between treated and untreated areas. Once the patient is flat and asleep on the operating room table, these markings give the surgeon a “road map” to the areas being suctioned.

Small access incisions are then strategically planned in inconspicuous locations to give access to the areas that will be suctioned. Each incision measures approximately 1/8″ -1/4″ of an inch or less. Incisions are generally placed in natural creases such as the buttock fold or behind the knees, in hair-bearing areas, or in the bikini/underwear line so they remain concealed.

At this point, the fat layer to be suctioned is injected with a tumescent saline solution as in traditional or tumescent liposuction techniques. This fluid environment helps the sound waves travel more efficiently in the fat, and helps reduce potential heat build-up from the procedure. The ultrasonic liposuction is then carried out and the injected saline solution is removed along with the liquified fat.

What Is The Recovery?

UAL is generally a procedure that can be done on an out-patient basis, so you come in and go home the same day. Patients normally remain in the recovery room for 1 1/2 – 2 hours following surgery, and are discharged home in the care of a responsible adult with specific instructions. Some patients may prefer to stay overnight for one to two days, and this can be arranged, if necessary, with registered nursing care.

Patients are encouraged to move about the next day as tolerated. Discomfort after the procedure is generally easily controlled with codeine type oral medications. After 3-5 days, most patients will be able to stop these medications completely and take ibuprofen or Tylenol for any residual discomfort.

Return to work times vary from patient to patient, and depend on patient motivation, the extent of the procedure, and the type of work they are returning to. While some patients return to work in as little as 3-5 days, most patients will take off approximately 1 week before returning to work. Without question, in today’s work conscious society, this has been one of the greatest surprise bonuses of ultrasonic liposuction – less pain, less bruising and swelling, and the ability to return to work much sooner if necessary.

Compression garments are given to the patient to wear for the first 2-3 weeks after the procedure to apply even gentle compression to the areas suctioned. Massage of the areas is started 7-10 days after the procedure, and patients are allowed to begin light exercise in one week. By 3 weeks, patients are generally allowed to resume all previous activities as tolerated.

What Are The Risks?

There are risks and potential complications with any surgical procedure, regardless of how big or small the procedure is. Liposuction, whether it is done in the traditional manner or with ultrasonic assistance, is no exception. Major complications are uncommon. Many of the potential complications with UAL are the same as with traditional liposuction.

The complication rate with UAL seems to go up if suctioning is done very close to the skin surface. Consequently, great care is taken to avoid bringing the tip of the wand close to the skin surface. The following is a list of possible problems that can arise following liposuction, both traditional and ultrasonically assisted.

  • Temporary change in skin sensation
  • Lumpiness and firmness that may occur as small areas of fat harden during the healing process
  • Accumulation of fluid in the suctioned areas (seromas), which may require aspiration with a small needle
  • Bruising and Swelling (minimal with UAL)
  • Skin surface irregularities or asymmetries (uncommon)
  • Brownish discoloration of the skin from the breakdown of iron in the blood in the tissues (uncommon)
  • Bleeding (uncommon with UAL)
  • Infection (uncommon)
  • Skin necrosis and burns (very uncommon) can be seen if suctioning is done too close to the skin

Who is a Good Candidate?

Liposuction of any type is ideally suited for people who are relatively close to their ideal weight, but have localized pockets of fat that make certain areas of their body seem disproportionate. These pockets are often resistant to diet and exercise. Ideal candidates are healthy, eat well, exercise regularly, and have good elasticity of their skin so it will shrink and re-drape well after the liposuction procedure.

Liposuction should not be considered a treatment for obesity or overall weight loss, nor is it an effective treatment for removing or smoothing cellulite. Patients with eating disorders such as anorexia or bulimia are generally not considered to be good candidates for liposuction.

Happy patients tend to be those who are well informed of what exactly liposuction can do in their specific instance and have realistic expectations

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