Liposuction

A common misconception amongst patients considering cosmetic surgery of the abdominal area is that the choice exists to have either a tummy tuck or liposuction and that either of these two procedures will produce similar results. In most cases, a patient is a far better candidate for either a tummy tuck or liposuction and the procedures are not interchangeable. The decision as to which plastic surgery procedure is best must be made in conjunction with a qualified plastic surgeon but the following is a general guideline: Typically, patients whose abdominal area has loose excess skin, or significant stretch marks will need a tummy tuck and will not benefit from liposuction alone. This is because liposuction is a procedure that only removes fat. Skin is essentially unaffected. Therefore if there is substantial loose skin or stretch marks to start with, liposuction will not remove any of the extra skin or any of the stretch mark-bearing skin. Furthermore, liposuction in these circumstances can actually worsen the problem by removing the "foundation" on which the skin rests, i.e. the underlying fat thereby leaving even looser skin than the patient started with. Liposuction to the abdominal area is more appropriate in cases of younger patients with firm, taut abdominal skin whose main problem is extra fat. In these cases, skin reliably shrinks over the liposuctioned area and a great cosmetic result can be obtained. Remember that this is only a guideline. The ultimate decision as to which procedure(s) is best for you should be made during a private consultation with a qualified surgeon.

Liposuction is intended to treat localized fatty deposits that are out of proportion with your body as a whole. It should not be regarded as a weight loss technique but rather a body contouring procedure to remove fat collections that are resistant to exercise and dieting. Liposuction can be performed on many different body areas from the face to the arms, abdominal area, and legs. Liposuction is also an excellent approach to treating gynecomastia, a condition in which a man develops abnormally large breasts. Although it can be performed in all age groups, liposuction results are best in younger individuals with firm and elastic skin. In cases with good skin elasticity, the overlying skin will not become excessive or loose once liposuction has been performed. In patients whose skin has lost elasticity, other procedures such as a tummy tuck or thigh lift may be more appropriate.

Liposuction can be performed either under local or general anesthesia. It is almost always a day surgery with no stay required.
Typically, liposuction involves multiple small incisions which allow Dr. Backstein to first infiltrate each area with solution containing local anesthesia and a vasoconstrictor (to decrease bruising) and then to aspirate unwanted fatty deposits using a liposuction cannula. The duration of the procedure depends on the amount of fat that requires removal.

Preparing for liposuction surgery involves mental preparation, a review of your current medications and vitamins, and following standard pre-operative instructions.
Mental preparation for liposuction is key to a pleasant post-operative recovery. It is important to understand that you are undertaking a very commonly performed procedure and that Dr. Backstein will have screened you pre-operatively to ensure you are a safe candidate for the procedure. Furthermore, liposuction by its nature is a safe procedure since the surgical work is carried out in a superficial plane of the body well away from large blood vessels or major organs.
It is equally important to understand that immediately post-operatively your body will look swollen, bruised and less natural than it will several weeks post-op.
Make sure you review any medications and vitamins at least two weeks prior to your surgical date. Medications such as anti-inflammatory drugs , blood thinners/anticoagulants and vitamin E products should be discontinued completely for at least two weeks prior to liposuction surgery in order to minimize the risk of extra bleeding during or after surgery. Multi-vitamins may contain vitamin E and should be stopped if vitamin E is present. Finally, be sure not to eat or drink anything at all from midnight of the day before your liposuction surgery so as to enter the operating room with an empty stomach.

Liposuction is typically not overly painful. Areas treated experience a dull ache that fades over the first 7- 10 days. Very few patients need to stay overnight unless they are from out of town or have no assistance at home. Patients can return to jobs requiring minimal physical activity after 3-7 days. Patients with more rigorous jobs may need 2 weeks off prior to resuming full duties Work outs can begin as soon as you feel able and comfortable. This is usually after the first week following liposuction surgery. Patients should wear a compressive garment provided by Dr. Backstein for the first 3-4 weeks post surgery.

Unfortunately, liposuction has received somewhat of a bad rap in the media. When done properly by a qualified plastic surgeon, liposuction should be a safe procedure. Most of the "horror stories" that one hears about through the media are easily explained. These cases can usually be attributed to unqualified medical practioners trying their hand at liposuction or cases in which overzealous surgeons remove too much fat in a single liposuction procedure. Complications associated with liposuction include:

bruising
swelling
blood clots
irregularities in contour (1-5 of every 100 patients will need a minor touch up)

During your consultation, Dr. Backstein will review the complications associated with liposuction in great detail. When done correctly, liposuction is a safe procedure with excellent body contouring results.

Liposuction has been at the centre of several high profile cases in which patients have died or had terrible cosmetic outcomes. In my opinion, the major reason for this is that liposuction is a rather unique cosmetic surgery procedure in which the liposuction machine does a great deal of the work involved with the liposuction procedure. Classic cosmetic surgery skills and techniques such as surgical dissection, meticulous incisions and suturing (stitching) do not play a large role in a liposuction procedure. Because of this, many untrained (ie. no Royal College of Canada certification in Surgery) doctors have developed unfounded confidence to purchase liposuction equipment and perform liposuction procedures in their offices. There are several doctors in Toronto and the GTA that have large practices in cosmetic surgery but are not qualified surgeons. Always remember to ask your doctor for his or her qualifications and make sure they are board certified in surgery.

Unfortunately, the answer is no. Contrary to popular belief, liposuction is not an effective treatment for cellulite. Cellulite is a dimpled appearance of the skin similar to the texture of an orange peel that is a result of fibrous attachments of the underside of the skin to the underlying muscles. Cellulite is not only found in people that are overweight but is also seen in fit and slim individuals. Because cellulite is not a result of excess body fat, liposuction is not effective in treating it. In fact there is no proved treatment for cellulite. All of the creams and topical ointments advertised on television are of little to no use for treating cellulite. A more recent treatment called endermology attempts to treat cellulite using a roller/suction device but the results are highly questionable and likely not significant. In short, we don't have a very good treatment for the problem of cellulite. Liposuction should not be advertised to patients as a means to treat cellulite because it will not work.

1. Keep your garments on until your first follow-up appointment with Dr. Backstein.
2. You can sponge bath but don't get the garment wet
3. Make sure you move around and get the circulation going, especially in your legs.
4. Do not lie in bed for hours at a time (except when sleeping at night)
5. You will very likely encounter leaking of reddish fluid onto your garment. This is not bleeding but is the release of some of the fluid infiltrated into the areas during the procedure. This can cause anxiety because it appears to be active bleeding but is not. Bear with it, it will stop after 24 hours or so. It is not unusual for one body area to leak more than other areas.
6. Contact Dr. Backstein at drbackstein@gmail.com if you have significant concerns.