Fat removal surgery is one of the most common cosmetic procedures, the popularity of which is growing every year. Modern methods are so advanced that they can remove more than 10 liters of adipose tissue, and minimally invasive technologies minimize the risk of complications.
How did liposuction appear?
A slender, fit figure is the ideal of beauty in modern society. The first fat removal operation was carried out as early as 1921 in France. And although it failed, it laid the foundation for a new direction in the beauty industry.
The following attempts were resumed only in the 60s of the XX century. The technology of that time cannot be called safe and effective - the fat was removed using a curette, scraping through small incisions in the skin. This was accompanied by a large number of complications, the development of inflammatory processes, the formation of rough scars. Tissue healing was also very long.
In 1974, one of the Italian gynecologists suggested using a hollow tube instead of a traditional curette, inside which sharp knives rotated. Three years later, a new type of instrument entered surgical practice, thanks to which fat was suctioned off. This technique has become widespread and formed the basis of modern technology.
In the 80s. XX century Swiss doctors came up with the idea of ​​impregnating fatty tissue with hyaluronidase in saline. The addition of the adrenaline hormone, which contributes to the narrowing of blood vessels, also significantly reduced the number of complications.
In medicine, there is a certain term, called the operation to remove fat, - liposuction. This definition was introduced by the president of the American Society of Plastic Surgeons.
In 1985, a modern composition of tumescent fluid (a mixture of saline, pain medication and adrenaline) was developed. Injections of fluid into adipose tissue made it possible to carry out this operation almost painlessly, with minimal blood loss and complications.
Indications
Indications for plastic surgery to remove fat are as follows:
- Removal of local fat deposits located on the abdomen in front and sides, on the inner and outer thighs, under the chin, in the middle and lower back, in the knees and shoulders.
- Comprehensive adjustment of proportions during abdominoplasty (restoration of abdominal proportions), ritidectomy (surgical face lift), mammoplasty (breast reduction) and other surgical interventions.
- Elimination of benign tumors. Most often, this technology is used for large lipomas.
- False gynecomastia in men - breast enlargement due to redistribution of adipose tissue.
- Elimination of hyperhidrosis (excessive sweating) in the armpits.
What cannot be fixed with liposuction
Contrary to popular belief among patients, the operation to remove excess fat is not intended for patients who have:
- Obesity. Overweight is corrected using other methods - dieting, taking special medications, psychotherapeutic and surgical treatment (shunting and banding of the stomach, sleeve gastroplasty). Moreover, liposuction is most effective in people with body weight close to normal. Such an operation is aesthetic in nature and is intended to correct uneven body fat, and not to normalize lipid metabolism.
- Cellulite, since it represents dystrophic changes in the surface layers of fatty tissue, and liposuction is carried out more deeply.
- Stretch marks (striae). This operation cannot correct the decrease in skin elasticity and increase its elasticity.
Contraindications
Contraindications for removing fat by liposuction are:
- pathology of the circulatory system, poor blood coagulation;
- severe diseases of internal organs and systems;
- endocrine obesity (pituitary type or due to thyroid pathologies);
- very low firmness and elasticity of the skin (since the removal of fat will lead to sagging and wrinkling);
- endocrine disorders (severe diabetes mellitus, uncompensated hypothyroidism and others);
- individual intolerance to drugs used during the procedure;
- heart, kidney, liver failure;
- inflammatory and purulent processes in the field of surgical intervention;
- chronic infectious diseases;
- pregnancy;
- any disease in the acute phase;
- immunodeficiency states;
- oncological pathologies.
Liposuction is not performed in women during menstruation. It is necessary to wait 5-7 days after their completion.
Before carrying out the operation to remove fat, the doctor should study the history and assess the risk of complications due to the presence of any disease. If it is large, then the operation must be abstained.
Types of Liposuction
The following types of liposuction are distinguished:
- Standard (traditional): dry and wet. Its advantages are simplicity and relative cheapness, and disadvantages include tissue trauma, a significant number of side effects. Great blood loss sometimes requires a blood transfusion.
- Tumecent. Such an operation is characterized by less blood loss, local and general complications, and a good aesthetic effect. In one procedure, you can remove up to 4-6 liters of fat.
- Ultrasonic The disadvantages include the high cost of equipment, and, consequently, the price of the procedure. Depending on the operating area, the efficiency can be either medium or high.
- Laser It shows good results in patients with reduced skin elasticity.
The last three species relate to non-invasive liposuction techniques. The choice of method depends on the location of body fat, the planned volume of surgery, the availability of necessary equipment and tools.
Traditional liposuction
Dry aspiration fat removal, introduced in practice in 1974, is the most traumatic. At present, cannulas of different diameters are used, and aspiration (suction) is performed in a gentle mode. This procedure is performed only in limited areas of the body and under general anesthesia.
More perfect wet liposuction is characterized in that the surgical area is pre-punctured with solutions. In both cases, there is a limit on the maximum amount of fatty tissue eliminated during this procedure - no more than 1 liter.
Tumecent Liposuction
The operation to remove fat in this case is similar to wet traditional liposuction. However, the tumescent solution, also called Klein solution, has a special recipe. There are also modifications of it, for example, sodium bicarbonate is introduced, which contributes to a more efficient penetration of fluid into the tissue. The basic composition described above remains constant.
The volume of the tumor solution is selected depending on the area of ​​surgical intervention. Its ratio with fatty tissue varies in the intervals 1: 1-1: 3. Aspiration begins in 20-30 minutes. The operation is also performed under general anesthesia.
Training
Preparation for liposuction, as for any planned surgical intervention, is the following tests and examinations:
- blood test (general, biochemical, for coagulability, for the presence of HIV, syphilis, hepatitis C and B, determination of the group and Rh factor);
- Analysis of urine;
- consultation of a mammologist and ultrasound of the mammary glands, if the operation is performed on the chest;
- ECG;
- examination by a gynecologist (women only);
- chest x-ray.
After passing the tests and studying the history, the therapist makes a conclusion about the state of health. The patient is also examined by an anesthetist who finds out if there are allergic reactions to drugs, what diseases and operations have been previously transferred, or if there are bad habits (since they can affect anesthesia). After surgery, compression garments may be required, which must be purchased in advance.
At least 1 week before the procedure, the patient should stop taking drugs that affect blood coagulation. These include drugs such as acetylsalicylic acid, polyunsaturated fatty acids, vitamins A, C, E; iron preparations. They can also not be drunk during the recovery period. On the eve of the operation, it is necessary to take a shower, and for 6-8 hours to refuse to eat and drink.
Conducting a standard liposuction procedure
Liposuction according to the traditional and tumescent method is carried out in stationary conditions. First, the doctor marks the problem areas on the patient’s body (marking of the surgical field) and the direction of probe movement.
With the wet method, operations to remove subcutaneous fat, this area is chipped with painkillers, and then a Klein solution is injected to thin and facilitate the removal of adipose tissue.
Then the surgeon makes small incisions 1-2 cm in size and inserts a cannula. It is a metal hollow tube. By moving the cannula, the doctor destroys the adipose tissue, which is then excreted by vacuum suction.
The duration of the procedure depends on its volume - from 30 minutes to 2.5 hours. On average, an operation to remove fat from the abdomen lasts 1.5 hours.
Rehabilitation period
The length of stay in the clinic depends on the general condition of the patient and the type of anesthesia - if it was local (with a small removal), then discharge can be made after 2 hours. If general anesthesia was used, then on average - after 1 day. This is due to the fact that detoxification therapy, elimination of water-electrolyte disorders, prevention of infectious complications and other therapeutic measures may be required.
One of the most important conditions for the prevention of complications is wearing compression underwear. Its use is indicated around the clock for 1-4 weeks. This is necessary so that the skin does not sag and to eliminate edema. During the recovery period, a low-salt diet is recommended. You should refrain from doing sports, sunbathing and bathing.
In the first 2-3 days, a sensation of pain and burning is possible, and in the area where the fat is removed, bumps and seals are observed. The final result becomes visible after a few weeks. After 14-20 days, the skin will begin to tighten, and the contours of the figure will smooth out. Restoration of normal activity occurs within 1-4 days. Physical activity is permissible after 1-2 months.
Side effects and complications
The following side effects and complications are characteristic of liposuction surgery:
- The appearance of hematomas, internal bleeding. Bruises form in almost all patients and pass on their own over time.
- Swelling.
- Pain syndrome (especially with traditional liposuction).
- Disruption of blood flow through the vessels, caused by the introduction of anesthetics with tumecent liposuction.
- The formation of scars and scars, "tuberosity" of the skin.
- The development of infectious inflammation.
- Numbness (loss of sensation). In severe cases, rehabilitation therapy may be required. Sometimes numbness becomes irreversible.
- Skin death in the aspiration zone. Most often, this complication manifests itself in elderly patients and in those who have chronic diseases or reduced immunity.
- During ultrasonic liposuction, in rare cases, probe failure, damage to internal organs, thermal burns, and the formation of accumulations of serous fluid are possible.
Risk factors for the occurrence of these negative phenomena are bad habits, the early onset of physical activity and the refusal to wear compression underwear.
Ultrasonic liposuction: features and technique
The difference between non-invasive liposuction using ultrasound is that after the introduction of a tumescent solution, fatty tissues are destroyed by ultrasonic waves. The emitting tip is always moved in the reciprocating direction, as long-term exposure to the same area can cause thermal damage. In one position, the tip should be no more than 2-3 s. Modern equipment allows replacement of the probe and removal of fat at the same time, during one operation.
The basis of this technique is the phenomenon of cavitation. Gases dissolved in the intercellular tissue, under the influence of mechanical vibrations created by ultrasound, merge and turn into micro bubbles, which collapse sharply. As a result, fatty tissue is destroyed, it becomes softer and is easily removed through thin tubes connected to an aspirator.
During the procedure, the surgeon evaluates the thickness of the fat fold by lifting the cannula or using a pinch, pinching the skin between the fingers. At the end of liposuction, he sutures and sterile wipes on the wounds. Then, compression garments are put on the patient, under which plates of foam rubber or silicone can be placed to obtain a greater leveling effect.
Laser Lipolysis
Another technology for removing fat without surgery is laser lipolysis, the destruction of fat cells by laser. Due to its high accuracy, this method can be used to affect small areas of the body, in particular, on the face. The laser beam also stimulates collagen production, which improves skin elasticity.
The technique of laser lipolysis is as follows: heads with an emitter are installed on the skin, which are fixed with straps. Then turn on the equipment for 10 minutes Passing through the surface layers, the laser beam hits the fat cells and opens their pores. Fatty acids, water and glycerin from the cells go into the intercellular space, and then are removed by the lymphatic system into the venous bed.
One course of treatment consists of 5-15 sessions, which are carried out every day or every other day. To increase efficiency, this procedure is combined with laser-vacuum massage. The decrease in the thickness of the fat layer ranges from 1-8 cm. The duration of one procedure is 0.5-1 hours.
The benefits of this exposure include the following:
- quick recovery, no need for hospitalization;
- good tolerance, fewer side effects (hemorrhage, bruising, bumps);
- lack of postoperative sutures.
Prices
There are several factors that influence how much a fat removal operation costs:
- applied technology;
- type of anesthesia;
- volume and area of ​​surgical intervention (if the total volume of fat removed is more than 10 l, then the price for an operation of one zone can reach 160 thousand rubles);
- level of the medical center and its location;
- the number of preliminary examinations and analyzes, consultations with specialized doctors (total costs may vary between 8-20 thousand rubles);
- the length of stay in the hospital (one day costs 3-6 thousand rubles);
- the need to wear a bandage (4-12 thousand rubles).
Therefore, the cost of this procedure is individual for each patient. Those prices that are listed on the websites of cosmetology clinics are only indicative and, as a rule, are indicated only for the operation itself. The average cost of liposuction in clinics in Moscow is the following (indicated in thousands of rubles):
- thigh area - 60-80;
- buttocks and lumbar region - 80;
- stomach (only its upper or lower part) - 45-50;
- the whole stomach is 80-90;
- chin, cheeks, knees - 20-30.
In some clinics, the price for liposuction of one zone is indicated, the area of ​​which is 10 cm 2 . On average, it is equal to 30 thousand rubles.