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Liposuction

Liposuction is a contouring procedure that removes bulges to blend body outlines more aesthetically. Age, heredity, and hormonal factors sometimes counteract our best efforts to attain the type of physical appearance we desire. Surgery, when indicated, can be combined with a program of fitness and nutrition to achieve and maintain long lasting results. Areas of the body where fat deposits can cause localized bulges include the face and neck, upper arms, upper and lower abdomen, flanks, hips (love handles), inner thighs, outer thighs (saddlebags), buttocks, knees, calves, and ankles. Dr. Forley precisely removes excess localized fat deposits through tiny incisions using a multiple cross-tunneling technique with small tubes called cannulae. The control he is able to maintain with this approach enables a very artistic sculpting of the body to achieve the desired result. Skin with good tone and elasticity will shrink or contract to fit the new body contour. If the elasticity of the skin has been compromised by pregnancy or extreme weight gain and loss, additional excisional procedures may have to be considered. Dr. Forley has evaluated a variety of new thermal based fat contouring technologies using laser and ultrasonic energy. He believes that equivalent results can be achieved when all techniques are performed well. However, the risk of temperature related complications that exists with the use of laser and ultrasound devices is not present with the non-thermal based liposuction technique that he favors. Non-surgical fat contouring technology using radiofrequency heat energy or controlled cooling to freeze fat cells has a role for smaller problem areas but often requires multiple treatment sessions with varying degrees of success.

Before After
40 year old female 6 months following liposuction of the outer thighs, inner thighs, hips, and abdomen

*Results may vary.

Is This For Me?

You should consider liposuction if:

  • You have been following a good regimen of diet and exercise yet can’t get rid of the excess fat of your tummy, hips, or thighs.
  • You are willing to engage in exercise and a healthy diet to maintain your results after the procedure.
  • The problem area is fat below the skin. Internal fat deep to the muscles cannot be removed with liposuction.
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The Consultation

During your consultation, Dr. Forley will first ask about your medical history and to describe what concerns you most about your appearance. He will examine you to assess your skin quality and the amount of skin and fat excess. Any surface irregularities will be evaluated for possible improvement. Your muscles will also be evaluated for strength and convexity to determine their contribution to the appearance of your body. The procedure will be explained in detail and you will be given an idea of realistic expectations for improvement with examples of before and after results. Dr. Forley will discuss strategic incision placement to minimize scar visibility. If skin elasticity is an issue, additional procedures involving skin excision will be discussed. You will have plenty of time to get all your questions answered.

Before After
30 year old female 5 months following liposuction of the abdomen

*Results may vary.

Preparation

Achieving a stable body weight is important for the best result. A program of healthy eating and moderate exercise prior to the surgery that is resumed after the recovery period will contribute to maintaining the optimal outcome. Instructions pertinent to reducing the risk of bleeding and bruising will be discussed during your pre-operative appointment two weeks prior to the surgery. A program of vitamins and supplements designed to enhance healing and minimize bruising and swelling will be provided to you for use before and after the surgery.

The Procedure

Dr. Forley will mark the planned locations for fat removal and confirm that all your questions have been answered. The anesthesiologist will then review with you the twilight/sedation method of anesthesia that is utilized exclusively in the Joint Commission accredited office surgical suite. The tumescent technique is used in which large volumes of fluid containing anesthetic and a blood vessel constrictor are placed directly into the fat compartment to be treated after you are asleep. This enables a more even removal of fat and decreases any blood loss as well as providing extended pain relief. Incisions less than a half-inch long are made in concealed areas and small suction tubes are inserted to reach the target fat deposit. The tube or cannula is then passed back and forth until an appropriate amount of fat has been removed through multiple fine tunnels. The entire bulging area is treated in this fashion, carefully removing small amounts at a time, and constantly checking fat thickness and contour as suctioning proceeds. Finally, the incisions are repaired with dissolvable sutures under the skin, and an elastic compression garment is placed to reduce swelling and bruising in the area with gentle pressure.

Before After
36 year old male 8 months following gynecomastia surgery of the chest and liposuction of the hips and abdomen

*Results may vary.

What to Expect After Your Procedure

You will have some swelling, bruising, and numbness over the areas that have been suctioned although you will see an immediate contour change. Most patients experience minimal discomfort, but there may be a few days of soreness, tightness, or fullness. An elastic compression garment is worn for 2-4 weeks following the procedure. Bruising and the initial phase of swelling usually resolve within 2-3 weeks or sooner coinciding with a gradual return of sensation. Patients are able to return to work in 3-4 days and resume exercise in 2 weeks. Contour definition with additional swelling resolution and skin contraction will continue to occur over 3-4 months, at which point the final result is evident. The results of liposuction are long term provided that you maintain a stable weight.

The Stages of Recovery

  • Day of surgery: Usually performed as an outpatient procedure in our accredited office surgery facility
  • Bruising and Swelling Resolve: 7-21 days with continued improvement in contour occurring up to 3-4 months
  • Return to work, social activity: 3-4 days
  • Aerobic or strenuous activity: 14 days

Potential Risks and Complications

Risks common to all surgical procedures such as bleeding, infection, and thickened scar tissue formation occur in a very small percentage of cases. We will give you more detailed information about these and other rare risks in our written information and encourage you to discuss any which concern you during your consultation.

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5 MYTHS ABOUT LIPOSUCTION 1. If I have liposuction, the fat will just go somewhere else on my body. Behavioral factors related to diet and exercise after your procedure will determine if fat going to other parts of your body is a myth or a reality. The reason that areas of your body that were not a problem before liposuction may become a problem is usually the result of consuming more calories than you use. If you are not maintaining an active lifestyle with a healthy diet and a reasonable amount of exercise, the calories you ingest on a daily basis will likely exceed what you burn for energy. As a result, these excess calories will be deposited in the form of fat. Since there are now fewer fat cells in the areas treated with liposuction, the fat will appear in other areas that were not previously prone to excessive fat deposits. 2. Liposuction is very painful. Although you will have some soreness and areas of discomfort in the first few days after your liposuction, most patients find it is very tolerable. Pain medication will alleviate most of the symptoms and is usually not needed after the first week. 3. Cellulite can be treated by liposuction. Cellulite CANNOT be treated by liposuction and in some cases may appear worse when underlying fat is removed. There are many new devices and technologies that claim to improve cellulite. Consistent long term improvement remains an unsolved problem. 4. I can have liposuction instead of losing weight on my own. Liposuction is not a procedure for weight reduction. It is used to selectively contour and shape areas of your body with excessive fat deposits. If the reasons you gained weight prior to the surgery are not addressed, the results will not be maintained. 5. All the fat in the problem area should be removed. We tend to think the less fat the better. In fact, the fat that remains after liposuction is important for creating a smooth surface contour. A thin, even layer of fat must be preserved during the procedure to achieve the best aesthetic outcome.
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  • New York Super Doctors

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