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Liposuction

Liposuction is a plastic surgery procedure which enables the removal of localized deposits of fat through extremely small incisions. The remaining skin shrinks back in order to achieve a slimmer contour. Because liposuction is unable to remove any excess skin, the best candidates are those with spot areas of fat, reasonable skin tone, and little extra skin. Liposuction can easily be performed in those patients that do not quite have these optimal anatomic characteristics. Expectations must be tailored and realistic in these cases. During your consultation, Dr. Chang will carefully review with you your specific anatomic characteristics and will help guide you to a surgical plan that best meets your expectations.

Liposuction is not a means of weight loss. It is instead designed to remove spot areas of fat that are resistant to diet and exercise. The most common areas of resistant fatty deposits include the abdomen, the “love handle” area (also known as the flanks), the outer and inner thighs, the arms, and the neck. (Figure 1)

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Figure 1

Multiple areas can be liposuctioned simultaneously. Depending upon the person, it is often more advantageous to perform liposuction in a circumferential manner in order to achieve the maximal slimming effect. (Figures 2,3,4, and 5)

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Figure 2

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Figure 3

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Figure 4

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Figure 5

The technique of liposuction uses a long thin cannula with holes in the end connected to a vacuum device. A few small 3mm incisions are made in order to access the areas of fat to be removed. A solution consisting of a salt solution, epinephrine, and lidocaine is then infiltrated into the area. This solution constricts the blood vessels to prevent bleeding and “plumps up” the fat cells so that the fat can be removed more easily and with less trauma. This procedure is known as the Tumescent technique type of liposuction. Once this tumescent solution has set, the cannula is inserted, and the fat is literally suctioned out. Dr. Chang advocates the use of smaller cannulas and employs a crossing technique in order to achieve the smoothest results possible.

Dr. Chang performs liposuction in a fully accredited San Francisco hospital with board certified anesthesiologists. The procedure is generally performed under a general anesthetic. Some smaller procedures can be performed with a sedation and regional anesthesia (such as a spinal anesthetic). The length of the procedure varies depending upon the amount of liposuction to be performed, and will need to be determined on an individual basis. Most patients can go home the same day with supervision, and only those with the largest amounts of fat removed will be recommended an overnight stay.

Postoperatively, patients will be fitted with a compression garment which they will need to wear continuously for a minimum of two weeks. This garment helps to decrease swelling, promote absorption of the tumescent solution, and allow for a more comfortable recovery. Depending upon the amount of liposuction performed, Dr. Chang recommends as little as a few days off work to a whole week. The initial recovery period is generally one week, and patients have no restrictions to activity and exercise by three weeks after surgery. Patients will notice the general shape improvements immediately. However it takes roughly three to six months for all of the final swelling to recede and for all the areas to completely soften again. During the initial postoperative period, patients may experience areas of firmness and even lumpiness. Often these areas are more palpable than visible. This is a normal phase of healing as the scar tissue created beneath the skin is gaining strength before it softens again. Dr. Chang will guide you through this phase of healing.

Liposuction has received some unfavorable press in past years for having complications. Most of these problems were related to the larger and larger amounts of fat that were being removed in one setting at that time. Dr. Chang authored one of the landmark papers in the plastic surgery literature addressing the issues involved in “Large Volume” liposuction and is very aware of risk prevention. When liposuction is performed in a controlled, conservative fashion, the risks of the procedure are very small. These generally include persistent numbness of the skin, pigmentary changes, and minor contour irregularities. Other risks include visible scars, bleeding, infection, blood clots, and anesthetic complications.

Liposuction is one of the ultimate procedures for achieving instant satisfaction. Certain fat deposits are resistant to diet and exercise. Liposuction addresses these spots extremely effectively and with minimal scars. With a steady healthy diet and exercise regimen, patients are thrilled to achieve their optimal shape.

Liposuction of the flanks, outer, and inner thighs

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Liposuction of the flanks, outer, and inner thighs

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Liposuction of the abdomen, flanks, outer, and inner thighs

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Liposuction of the abdomen

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Liposuction of the arms

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Liposuction of the chin

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This gallery represents only a small selection of photos available for viewing. Additional before/after results are available at the time of your appointment.